Published online June 30, 2006
PEDIATRICS Vol. 118 No. 2 August 2006, pp. e460-e470 (doi:10.1542/peds.2005-1257)
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REVIEW ARTICLE

Immunizations for Patients With Metabolic Disorders

Jeffrey D. Kingsley, MDa, Meera Varman, MDa,b, Archana Chatterjee, MD, PhDa,b, Rae A. Kingsley, MSNc and Karl S. Roth, MDb,d

a Division of Pediatric Infectious Diseases
d Combined Division of Metabolism, Creighton University Medical Center and University of Nebraska Medical Center, Omaha, Nebraska
b Department of Pediatrics, Creighton University Medical Center, Omaha, Nebraska
c Children's Hospital, Omaha, Nebraska

Individuals with underlying metabolic disorders are a potential high-risk group for vaccine-preventable diseases. Newborn metabolic screening has provided a means of early identification and treatment for many of these disorders, whereas childhood immunization is one of the most effective means of decreasing the morbidity and mortality resulting from communicable diseases worldwide. There are very few contraindications to the routine administration of vaccines to the healthy, immunocompetent individual. In certain high-risk groups, such as immunocompromised patients, gravid females, and those with a history of previous anaphylactic reaction to a vaccine or its components, selective withholding of immunizations must be considered to decrease potential adverse events. A detailed analysis of the medical literature revealed few specific recommendations regarding appropriate immunization techniques for patients with metabolic disorders. In this review we detail the major metabolic disorder subtypes, elaborate on the available literature on immunizations for patients with these disorders, and provide suggested vaccine recommendations.

Key Words: immunizations • vaccines • metabolic diseases/disorders • public health

Abbreviations: DTaP—diphtheria-tetanus-acellular pertussis • PKU—phenylketonuria • NTBC—2-(2-nitro-4-trifluoromethyl benzoyl)-1,3-cyclohexanedione • Ig—immunoglobulin • SCID—severe combined immunodeficiency • MCAD—medium-chain acyl-CoA dehydrogenase • GSD—glycogen-storage disease • P5'N-1—pyrimidine 5'-nucleotidase deficiency

Accepted Feb 17, 2006.


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