A 14-month-old child with known congenital immunodeficiency (severe combined immunodeficiency, SCID) is brought for routine immunization. Which vaccine schedule modification is MOST appropriate?

• A All vaccines should be deferred until immunodeficiency is treated
• B Only inactivated polio vaccine (IPV) should be withheld; other vaccines can be given
• C Killed/inactivated vaccines may be given; all live attenuated vaccines are contraindicated ✓
• D BCG and live oral typhoid vaccine are safe; only OPV is contraindicated

Explanation

In severe combined immunodeficiency (SCID) and other severe primary immunodeficiencies, all live attenuated vaccines are absolutely contraindicated because the child cannot mount an immune response to control vaccine-strain replication, risking vaccine-induced disease. This includes BCG (causes disseminated BCG-osis), OPV (vaccine-associated paralytic polio), MMR, varicella, rotavirus, yellow fever, and live oral typhoid. Inactivated vaccines (IPV, DTwP/DTaP, hepatitis B, Hib, PCV, inactivated influenza) are safe to administer but may not provide adequate immune response. BCG should be deferred at birth if SCID is suspected in the family history.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.