[Vaccination and infection protection in patients with acquired or congenital immunodeficiency]

INDICATIONS FOR VACCINATIONS IN IMMUNODEPRESSED PATIENTS: The indication for vaccination depends on the demonstration of their efficacy and tolerance. Few studies have demonstrated a clinical benefit in this heterogeneous population and generally have enrolled splenectomized patients.

Basically, the efficacy of vaccination is assessed from the post-vaccinal immune response which is generally altered in immunodepressed patients. This is specifically demonstrated for polysaccharide anti-pneumococcal vaccine. Thus, classical vaccinations with minimal immunogenic power that do not induce a memory response are not particularly effective for these patients. Indications are very controversial.

Recently developed conjugated vaccines (anti-haemophilus, anti-pneumococcal vaccines) are more immunogenic and offer interesting perspectives for new vaccination strategies in immunodepressed patients with a major risk of severe infection or infection caused by resistant strains.