[PAGID] Yellow fever vaccine in SDS?

[Jack Bleesing]

Esther:
 
You are right, you cannot give a 100% guarantee. The MMR was in the past. Due to an emphasis on bone marrow failure disorders within my BMT group, it has become clear to me that there is much more to learn about the immune system in SDS (and SDS-like, a much bigger group) patients. 
 
Since this appears to be an "elective" visit to Kenia (assuming that the family doesn't have to go there), I would empower the family to find things out for themselves as well (maybe they already have/are). What might be helpful for them is:
 
http://www.shwachman-diamond.org/index.htm 
 
Regards,
 
J
 
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Jack J.H. Bleesing, M.D., Ph.D.
Associate Professor of Pediatrics
Cincinnati Children's Hospital Medical Center
Division of Bone Marrow Transplantation and Immune Deficiency
3333 Burnet Avenue, MLC 7015
Cincinnati, OH 45229
513-636-4266 (phone)
513-636-3549 (fax)



>>> "Church, Joseph" <JChurch at chla.usc.edu> 8/6/2010 9:48 AM >>>


SDS patients often have selective antibody deficiency.  If there is time, I suggest you check antibody titers to previous vaccines.  If these are normal you would have more evidence that the YF vaccine should be tolerated.
 
Joe Church
Childrens Hospital Los Angeles
 
-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Dr. Esther de Vries
Sent: Friday, August 06, 2010 1:09 AM
To: pagid at list.clinimmsoc.org 
Subject: [PAGID] Yellow fever vaccine in SDS?
 
Dear all, I have a 10-year-old SDS patient who is clinically doing very well. He has relapsing mild granulocytopenia, stable bone marrow smears, and had some bouts of unexplained rheumatoid-like arthritis a few years ago. Because he is doing so well, the parents want to visit southern coastal Kenia with him, an area where yellow fever does not occur very often. He received MMR without problems in the past. The parents prefer to give him a yellow fever vaccine if possible, but the doctor at the tropical travel service is reluctant, and wants my permission. Since this is a live attenuated vaccine, and abnormalities in T-lymphocyte function in SDS patients have been published, I cannot give a 100% guarantee of safety. Does anyone have experience with this vaccine in SDS? Thanks! Esther de Vries, 's-Hertogenbosch, the Netherlands


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