Vaccination in immunosuppressed individuals planning a trip to the tropics

Somia Iqtadar, MD, is an associate professor of medicine at King Edward Medical University, Pakistan, and chairperson of the Dengue Expert Advisory Group. Her areas of interest include cardiometabolic medicine and infectious diseases.

What are the key principles of vaccination in immunosuppressed individuals planning a trip to the tropics?

Somia Iqtadar, MD: Vaccination in immunosuppressed individuals planning a travel to tropical destinations requires careful consideration because of their altered immune response. The key principles that should be kept in mind are the immunosuppression level of that particular individual, then, the potential risk of vaccine-preventable diseases in that particular destination, and you have to weigh the risk versus benefit of giving vaccination to that person.

Inactivated vaccines are generally preferred over live vaccines because of their minimal side effects in these individuals. However, all these considerations should be kept in mind in consultation with the travel medicine expert, infectious disease specialist, and the treating physician who is managing the disease in that individual.

It is important to note that the timing of the vaccine is also very crucial because—depending upon the immunosuppression therapy they are going [through] and the regime that they are following for their disease—sometimes vaccinations are given before the initiation of the immunosuppression therapy.

So, a tailored vaccination approach in consultation with a travel medicine expert, infectious disease specialist, and the expert managing that immunocompromised individual will maximize the benefit and minimize the adverse effects that could be related to vaccination in that individual.