By: Monica I. Ardura DO, MSCS, FAAP, FPIDS
While your child is busy playing and learning, their immune system is also at work. It responds to the thousands of germs your child comes across every day.
A healthy immune system generally handles many germs well. Vaccines help it learn quickly how to recognize and respond to certain bacteria and viruses that cause serious diseases.
When a child has lower immunity
Some children have lower immunity. This is sometimes described as being "immunocompromised," which means the immune system is weaker and may have a harder time responding to germs.
But what causes lower immunity? Should children with lower immunity get the same vaccines other children get? How do medical treatments affect their immunity? And what can parents do to help keep their children with lower immunity healthy?
Find the answers to these and other important questions here.
What causes a weakened immune system in children?
Lower immunity can last for a short time or a long time. It depends on the cause. Some reasons for lower immunity include:
Being born with a weaker immune system
Taking medicines that weaken the immune system
Getting treatments like an organ or bone marrow transplant, chemotherapy or radiation
Children with lower immunity can get sick more than other kids—and infections can be more serious in their case. They can end up in the hospital.
Your pediatrician is a trusted partner to help keep your child healthy. They can help you take steps to make your child’s immune system stronger.
Should children with weakened immune systems get vaccines?
Yes, children with weakened immune systems can and should get some vaccines. Vaccines teach a child’s immune systems to recognize and resist the most dangerous germs.
For a child with lower immunity, a pediatrician may also recommend extra or early doses of a vaccine. They could also recommend a vaccine with a different formulation.
An extra dose or an additional vaccine may give your child more protection. It can help their immune system respond better to different types of germs.
The
AAP recommended immunization schedule is designed to protect children at the ages when they need it the most. It matches how children’s immune systems work and when they're most likely to be exposed to certain diseases.
Are vaccines safe for kids with weakened immune systems?
There are two kinds of vaccines for children and teens in the United States. One uses "dead" germs. The other uses weakened germs.
Vaccines with "dead" germs are called non-live. Vaccines with weakened germs are called live attenuated.
Non-live vaccines are safe for children with lower immunity. Live attenuated vaccines may not be safe for some children with weakened immunity.
Talk to your pediatrician. They can help you find out which vaccines your child needs. They can also tell you if your child can safely receive non-live vaccines or not.
What is a non-live vaccine?
A non-live vaccine uses a "dead" version of the virus or bacteria that causes a disease. It teaches your child’s immune system to recognize and resist the germ. It cannot give your child the disease. These vaccines are usually safe for children with lower immunity.
Inactivated vaccines include:
What is a live attenuated vaccine?
A live attenuated vaccine uses a weakened form of a virus or bacteria. Many children with lower immunity may not be able to get this kind of vaccine. Talk with your pediatrician about which vaccines are best for your child.
Weakened live vaccines include:
Should children with weakened immune systems get vaccines before or after medical treatment?
It’s usually best for your child to get the vaccines they need for their age before any treatment that affects their immune system.
Your child might need treatment like chemotherapy or an organ transplant. In that case, your pediatrician might recommend getting any needed vaccines two to four weeks before those treatments start.
Some medications or treatments can weaken your child’s immune system. Then their immune system might not respond as well when it bumps into a dangerous germ. Because of this, your pediatrician may say your child needs to get vaccines before treatment begins. This gives the body’s immune system time to build protection while it is still strong.
Getting your child’s vaccines after treatment
It is not always possible to complete vaccinations before treatment starts. For example, some children can’t the vaccines appropriate for their age before their cancer diagnosis or the start of chemotherapy.
When that happens, your pediatrician may say your child can get some vaccines (influenza IIV and COVID-19) while receiving chemotherapy but will need to catch up on other vaccines after treatment.
Your child may be able to start the other vaccines 3 to 6 months after they get the last doses of chemotherapy. Depending on the type of chemotherapy, they may have to wait 6 to 12 months after chemotherapy is done.
Your child may only get inactivated vaccines. In some cases, a pediatrician may say live vaccines are safe. It depends on the individual situation of your child.
Talk with your pediatrician about what’s the best option for your child with lower immunity. Your pediatrician knows their medical history and has the knowledge and experience to guide you.
How can parents protect a child with a weakened immune system?
Cocooning
In addition to vaccines, another way to help protect your child is called "cocooning". This means everyone in your home and other close contacts of your child are up to date on their vaccines — including the annual COVID-19 and flu shots, too.
Sometimes, children with lower immunity can get serious diseases even if they’ve been immunized. They are especially at risk for diseases like measles if they can’t get the MMR vaccine.
There are less possibilities that a child with lower immunity gets measles when everyone in their home and their close contacts are up to date with vaccines. When family and caretakers are fully vaccinated, children have another protective layer that keeps disease away.
Understanding community immunity
Fewer germs can spread when many people are vaccinated. That is called community immunity. It helps protect everyone—especially children with lower immunity.
Many children with lower immunity can’t get live vaccines. That means they are not protected against dangerous germs.
On top of that, the protective response the body learns from vaccines may not be as strong in the case of children with lower immunity. So, even if they get non-live vaccines, they may still have a higher risk to get sick than children with healthy immune systems.
That is why when people around them are vaccinated, there is less chance dangerous germs will reach them.
Measles and whooping cough outbreaks happen in communities where fewer people get vaccinated. When fewer people get vaccines, germs spread more easily. This can be dangerous for children with weakened immune systems. They have a higher risk of getting seriously sick from these vaccine-preventable infections.
Remember
Children with weakened immune systems may get sick more, but there are steps you can take to protect them.
Vaccines are an important tool, though some children may need different vaccines types,timing, or doses.
Your pediatrician can help create a vaccine plan that’s right for your child. Making sure close family members are vaccinated also helps keep your child safer.
More information
About Dr. Ardura
| Monica I. Ardura, DO, MSCS, FAAP, FPIDS, is a Professor of Clinical Pediatrics at The Ohio State University College of Medicine. She is also a pediatric infectious disease specialist and Medical Director of the Host Defense Program at Nationwide Children’s Hospital. Dr. Ardura’s clinical and research interests are prevention, diagnosis and treatment of infections in immunocompromised children. She is a member of the American Academy of Pediatrics (AAP) Ohio Chapter Child Health Pillar and the AAP Committee on Infectious Diseases.
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