Use and interpretation of diagnostic vaccination in primary immunodeficiency: A working group report of the Basic and Clinical Immunology Interest Section of the American Academy of Allergy, Asthma & Immunology

• Published in: Journal of allergy and clinical immunology Vol. 130; no. 3; pp. S1 - S24
• Main Authors: Orange, Jordan S., MD, PhD, Ballow, Mark, MD, Stiehm, E. Richard, MD, Ballas, Zuhair K., MD, Chinen, Javier, MD, PhD, De La Morena, Maite, MD, Kumararatne, Dinakantha, MBBS, DPhil, Harville, Terry O., MD, PhD, Hesterberg, Paul, MD, Koleilat, Majed, MD, McGhee, Sean, MD, Perez, Elena E., MD, PhD, Raasch, Jason, MD, Scherzer, Rebecca, MD, Schroeder, Harry, MD, PhD, Seroogy, Christine, MD, Huissoon, Aarnoud, MB BCh, PhD, Sorensen, Ricardo U., MD, Katial, Rohit, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-09-2012; Elsevier
• Subjects: Allergy and Immunology; antibody deficiency; antigen challenge; Bacterial Capsules - immunology; Bacteriophage phi X 174 - immunology; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; common variable immunodeficiency; diagnosis; Fundamental and applied biological sciences. Psychology; Fundamental immunology; guideline; Haemophilus Vaccines - immunology; Humans; Immunity, Humoral; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunologic Deficiency Syndromes - diagnosis; Immunologic Deficiency Syndromes - immunology; Immunopathology; Medical sciences; neoantigen; Pneumococcal Vaccines - immunology; Pneumology; primary immunodeficiency; Rabies Vaccines - immunology; Salmonella Vaccines - immunology; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; specific antibody deficiency; Vaccination; Vaccines; United States; North America; America; MCV; KLH; Vaccines; PRP; primary immunodeficiency; RFFIT; US Food and Drug Administration; PIDD; Transient hypogammaglobulinemia of infancy; neoantigen; Wiskott-Aldrich syndrome; PCECV; diagnosis; Advisory Committee on Immunization Practices; common variable immunodeficiency; AT; guideline; Meningococcal polysaccharide vaccine; SAD; antigen challenge; Ataxia telangiectasia; Serum bactericidal assay; AAAAI; Pneumococcal conjugate vaccine; FDA; PCV; antibody deficiency; WAS; Human diploid cell vaccine; American Academy of Allergy, Asthma & Immunology; XLA; X-linked agammaglobulinemia; HDCV; CVID; SBA; THI; ACIP; Keyhole limpet hemocyanin; PPV; Primary immunodeficiency disease; Meningococcal conjugate vaccine; HIB; MPSV; Adenosine deaminase; specific antibody deficiency; Rapid fluorescent focus inhibition test; Pneumococcal polysaccharide vaccine; Purified chick embryo cell vaccine; Haemophilus influenzae type b; ADA; Polyribosylribitol phosphate; Allergy; vaccines; Vaccination; Prevention; Immunology; Primary; Bronchus disease; Obstructive pulmonary disease; Diagnosis; Lung disease; Immunopathology; Respiratory disease; Antibody; Deficiency; Use; common variable immnnodeficiency; Vaccine; Interpretation; Immune deficiency; Section; Recommendation; Asthma; Antigen; Neoantigen
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2012.07.002

A major diagnostic intervention in the consideration of many patients suspected to have primary immunodeficiency diseases (PIDDs) is the application and interpretation of vaccination. Specifically, the antibody response to antigenic challenge with vaccines can provide substantive insight into the status of human immune function. There are numerous vaccines that are commonly used in healthy individuals, as well as others that are available for specialized applications. Both can potentially be used to facilitate consideration of PIDD. However, the application of vaccines and interpretation of antibody responses in this context are complex. These rely on consideration of numerous existing specific studies, interpolation of data from healthy populations, current diagnostic guidelines, and expert subspecialist practice. This document represents an attempt of a working group of the American Academy of Allergy, Asthma & Immunology to provide further guidance and synthesis in this use of vaccination for diagnostic purposes in consideration of PIDD, as well as to identify key areas for further research.