A 14-month-old boy with Kawasaki disease received IVIG 2 g/kg three weeks ago. His MMR vaccine is now overdue. What is the MOST appropriate recommendation?
- A Give MMR immediately, IVIG does not affect live vaccines
- B Defer MMR for 4 weeks from the IVIG dose
- C Defer MMR for approximately 11 months from the IVIG dose ✓
- D Give MMR now and repeat the entire course after 6 months
Correct answer: C. Defer MMR for approximately 11 months from the IVIG dose
Explanation
High-dose IVIG contains pooled antibodies against measles and other viruses and passively neutralizes live attenuated vaccines. After 2 g/kg IVIG, MMR and varicella should be deferred for about 11 months, the interval needed for circulating passive antibody to fall below levels that block vaccine virus replication. A 4-week interval applies only to low-dose preparations such as tetanus immunoglobulin. Repeating a full extra course is unnecessary once the correct interval is observed.
Reference: AAP Red Book: Report of the Committee on Infectious Diseases, 32nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.