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A brief guide to immunisation and the immunocompromised child or young person

02 January 2023
Volume 34 · Issue 1


Vaccination of immunocompromised children is challenging both in regards to efficacy and safety. Chloe Watson, Barbara Davies and Claire Camara provide a brief overview

Immunisation in children with a compromised immune system is not straightforward. Children with autoimmune disorders are especially at risk of vaccine-preventable diseases due to their underlying disease and the immunosuppressive treatment that is often required for a long period. This article explores some of the complexities that need to be considered when planning individual vaccination programmes.

A healthy immune system protects the body against infections, fights infections when they occur and supports tissue repair following damage. The immune system is made up of a network of organs, cells, and proteins that work together to generate immune responses when pathogens enter the body (Simon et al, 2015; Davies et al, 2021).

There are two parts to the immune system: the innate system and the acquired system. Innate immunity is the body's natural defence system, which includes physical barriers such as the skin. Acquired immunity occurs when the body produces or receives antibodies, through exposure to disease or infection or through vaccination (Warburton, 2018). Vaccines can either contain weakened or inactive antigens or mRNA coding for the antigen that triggers an immune response within the body. This causes the white blood cells to produce complementary antibodies and memory cells. The antibodies target and attach to the antigen, allowing for phagocytosis. Regardless of whether the vaccine is made up of the antigen itself or its mRNA it will not cause the disease in the person receiving the vaccine, but it will prompt their immune system to respond much as it would have on its first reaction to the actual pathogen (World Health Organization (WHO), 2020).

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