[CIS PIDD] [cis-pidd] Yellow Fever Vaccine in sIgAD

[Cunningham-Rundles, Charlotte]

The CDC is of course wrong on this, but expect that is the only  answer they
can give on such a  phone call.



Charlotte Cunningham-Rundles, MD, PhD
Departments of Medicine and Pediatrics
The David S Gottesman Professor
The Immunology Institute
Mount Sinai School of Medicine
1425 Madison Avenue
New York, NY 10029
Phone: 212 659 9268
Fax: 212 987 5593
Email: Charlotte.Cunningham-Rundles at mssm.edu





> From: Jack R <jroutes at mcw.edu>

> Reply-To: "cis-pidd at lists.clinimmsoc.org" <cis-pidd at lists.clinimmsoc.org>

> Date: Wed, 3 Jul 2013 13:08:51 +0000

> To: "cis-pidd at lists.clinimmsoc.org" <cis-pidd at lists.clinimmsoc.org>

> Subject: Re: [cis-pidd] Yellow Fever Vaccine in sIgAD

> 

> I disagree with the CDC recommendation and do not believe your patient has IgA

> deficiency

> 

> 

> 

> 

> John M. Routes, MD

> Chief, Section of Allergy and Clinical Immunology

> Professor of Pediatrics, Medicine, Microbiology and Molecular Genetics

> Department of Pediatrics

> Children's Hospital of Wisconsin

> Medical College of Wisconsin

> 9000 W. Wisconsin Ave.

> Milwaukee, WI  53226-4874

> Phone: Office 414-266-6840

> Fax: 414-456-6487 (Clinical)

> Fax: 414-456-6323 (Laboratory)

> Email: jroutes at mcw.edu<mailto:jroutes at mcw.edu>

> 

> 

> 

> 

> 

> On Jul 2, 2013, at 6:21 PM, Yeşim Yılmaz Demirdağ

> <dryesimyilmaz at gmail.com<mailto:dryesimyilmaz at gmail.com>> wrote:

> 

> Dear all,

> 

> I would like to bring the "Yellow Fever vaccine and IgA deficiency" topic back

> to the group discussion. Last discussion concluded that YF vaccine is not

> contraindicated in IgA deficiency.

> 

> I received an e-mail today from a colleague. His patient, a 25 yo woman with

> history of Grave's disease, is planning to visit Ghana and she needs Yellow

> Fever vaccination. She had slightly low IgA and IgM 3 years ago (checked

> during Grave's work-up). She does not have recurrent infections and she is

> otherwise healthy. She and her father contacted CDC and were told that YF

> vaccine is contraindicated in selective IgA deficiency and they were given

> this reference  http://www.cdc.gov/mmwr/pdf/rr/rr6002.pdf  (Table 13 on page

> 48). I was not aware of this publication, so I wanted to let you all know

> about it and ask your opinion.

> 

> Back to the patient: Her recent IgA level is 49 mg/dl (70-312), IgM is 43

> mg/dl (56-352) and IgG is 913 mg/dl (639-1349).  I am not impressed by these

> values. But the family is reluctant. What would you recommend for this

> patient? Does she have selective IgA deficiency? What about slightly low IgM?

> Do you think this combination should be a contraindication for the vaccine?

> 

> Dewton, you mentioned that YF vaccine is widely used in inland Brazil. Do you

> have any data on the frequency of IgA deficiency in patients who developed

> severe reaction to this vaccine?

> 

> Thank you,

> 

> Yesim

> 

> 

> 

> Yesim Yilmaz Demirdag, MD

> Assistant Professor of Pediatrics

> Division of Allergy and Immunology

> Columbia University Medical Center

> New York

> 

> 

> 

> 

> 

> 

> 

> 

> On Wed, Jun 19, 2013 at 1:13 PM, Church, Joseph

> <JChurch at chla.usc.edu<mailto:JChurch at chla.usc.edu>> wrote:

> Colleagues:

> 

> A 20+ year old patient is traveling to Africa and is recommended to receive

> Yellow Fever Vaccine.

> 

> She has selective IgA deficiency.  Assuming she does not have an antibody

> deficiency is there a contraindication to giving  her the YF vaccine?

> 

> Joe Church

> Children’s hospital Los Angeles

> 

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