पृष्ठभूमि
Neutropenia is a condition where a person has a lower than सामान्य number of neutrophils. Neutrophils are a type of white blood cell responsible for fighting bacterial and fungal infections. Neutropenia is an immunocompromising condition that can be acute (temporary) or chronic (longterm) और है caused by certain medications or therapies, autoimmune conditions, infections, or other medical conditions.
Neutropenia and vaccines
Due to their lowered immunity, मैंराividuals with eutropenia are more vulnerable to infectionएस and their complications, meaning protection is a priority. However, protection is complicated since some vaccines are contraindicated due to the risk of vaccineassociated disease. The following guidance refers to the immunisation of individuals with longterm या chronic neutropenia.
Recommendations
निष्क्रिय टीके
It is recommended and safe for people with chronic neutropenia to receive inactivated vaccines as per the routine National Immunisation Program (NIP) schedule. Given patients with neutropenia are at increased risk of bacterial infections, अतिरिक्त न्यूमोकोकल एre also recommended. वार्षिक मैंnfluenza vaccination is recommended for those aged 6 months and older.
Liveattenuated viral vaccines
Neutropenia itself is नहीं a contraindication to live‑attenuated viral vaccines, as patients with an isolated neutropenia would be expected to handle viral infections, and correspondingly live‑attenuated viral vaccines, in most circumstances.
In cases of an undefined neutropenia some caution should be exercised, given neutropenia can occur in the setting of conditions which also affect lymphocyte (another type of white blood cell) number and function.
A number of patients with chronic moderateगंभीर neutropenia (neutrophil count < 1×10^9/L) will not have a defined molecular defect; the cause may be unclear, or they may have suspected immune neutropenia for which there is no diagnostic test. In these patients, an evaluation for an underlying immune defect is recommended prior to administration of live‑attenuated viral vaccines (e.g. रोटावायरस, MMR और वैरीसेला). If there are no concerning features on history, examination or screening investigations, live‑attenuated viral vaccines are recommended, as per the NIP. If any abnormalities or concerns are raised, a formal immunology consult should be sought prior.
In patients for whom the neutropenia is expected to be transient, or further investigation is planned in the near future (e.g. bone marrow examination or molecular studies), consideration should be given to delaying live‑attenuated viral vaccines until this information is available.
Live‑attenuated viral vaccines are contraindicated in patients with other inborn errors of immunity, such as leucocyte adhesion disorder, Chediak–Higashi syndrome or other defects in cytolytic granule release.
Live‑attenuated bacterial vaccines
Live‑attenuated bacterial vaccines (for example, the mycobacterial बीसीजी vaccine, oral typhoid (Vivotif) vaccine) are generally contraindicated in patients with neutropenia, including those with some phagocytic cell defects. This is due to an increased risk of टीकाassociated adverse events in this group, including delayed healing at the BCG site. When indicated, typhoid protection can be provided by using the alternate inactivated vaccine (Typhim Vi).
If there is a high risk of tuberculosis exposure in an individual with neutropenia, such as travel to a endemic area to visit friends and relatives (VFR), BCG vaccine should be discussed with both an immunisation specialist and haematologist.
संसाधन
- Australian Immunisation Handbook: Phagocytic and neutrophil disorders: recommendations for vaccination
- Australian Immunisation Handbook: Risk conditions for Pneumococcal Disease
- ऑस्ट्रेलियन इम्युनाइजेशन हैंडबुक: उन लोगों के लिए टीकाकरण जो प्रतिरक्षा में अक्षम हैं
- 2013 IDSA Clinical practice guideline for vaccination of the immunocompromised host
- Medical advisory committee of the immune deficiency foundation: Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts 2014
- Canadian Immunisation Guide: Immunization of immunocompromised persons
- Martire B, Azzari C, Badolato R, Canessa C, Cirillo E, Gallo V, et al. Vaccination in immunocompromised host: Recommendations of Italian Primary Immunodeficiency Network Centers (IPINET). Vaccine. 2018;36(24):3541-54
लेखक: Luisa Clucas (Clinical Haematology Registrar, Royal Children’s Hospital), Anthea Greenway (Head of Clinical Haematology, Royal Children’s Hospital), Theresa Cole (Consultant, Allergy and Immunology, Royal Children’s Hospital), and Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute)
द्वारा समीक्षित: Nigel Crawford (MVEC Director) and Rachael McGuire (MVEC Education Nurse Coordinator)
तारीख: July 2025
नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।
You should not consider the information on this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.