The pediatric immunization schedule includes multiple vaccines that protect against a series of important bacterial and viral pathogens. These vaccines consist of either live attenuated, killed or inactivated agents, or toxoids or bacterial polysaccharides conjugated to proteins. Live attenuated viral vaccines mandated for children are the measles-mumps-rubella (MMR) and oral polio vaccines (OPV). Other available live vaccines include varicella, vaccinia,yellow fever, and BCG typhoid Ty21a (oral).

Immunocompromised patients can be immunized safely with killed or inactivated vaccines, although the efficacy of immunization may be diminished. However, special considerations apply to the administration of live vaccines to children whose immune systems are compromised, who may be categorized into distinct groups:

Children in the first category should not be immunized with live viral vaccines. Uninhibited by an effective host immune system, the vaccine virus may replicate sufficiently to cause disease. In addition, OPV should not be given to household contacts of immunocompromised...

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