The Advisory Committee on Immunization Practices to the US Centers for Disease Control and Prevention provides annual recommendations for routine adult immunizations. Many recommendations consider patient factors such as age, medical conditions, and medications that increase an individual’s risk for infection with a vaccine-preventable disease. These factors, particularly those that lead to immunocompromise, may also alter the risk-benefit ratio for live vaccines, and/or lead to decreased vaccine immunogenicity and effectiveness. The provider may need to consider alternative vaccination strategies, including higher antigen dose vaccines, adjuvanted vaccines, avoidance of live vaccines, and careful timing of vaccination to optimize safety and effectiveness in immunocompromised populations. This thematic review discusses general principles regarding immunization of adults across the spectrum of immunocompromise, examines current guidelines and studies that support them, and outlines future research needs.

美国疾病控制与预防中心的免疫实践咨询委员会为成人常规免疫提供年度建议。许多建议都考虑了患者因素，例如年龄，医疗状况和药物，这些因素会增加个人感染可预防疫苗的疾病的风险。这些因素，尤其是那些导致免疫功能低下的因素，也可能改变活疫苗的风险收益比，和/或导致疫苗免疫原性和有效性降低。提供者可能需要考虑替代的疫苗接种策略，包括更高抗原剂量的疫苗，佐剂疫苗，避免活疫苗以及谨慎的疫苗接种时机，以优化免疫受损人群的安全性和有效性。