Vaccination of immunocompromised children — formative SAQs

SAQ 1 (10 marks)

A four-month-old boy born overseas, now in Australia, is due for his routine immunisations. There is no newborn severe combined immunodeficiency (SCID) screening result on file. His maternal uncle died in infancy. He has persistent oral thrush and has crossed two weight centiles downward. His mother asks whether he can have his usual needles today. ^{[1] [5]}

a) State the single most important safety decision you must make before any vaccine is given today, and the specific group of vaccines that is at risk. (2 marks) ^[1]

b) List four features in this vignette that justify withholding live vaccines and investigating further. (2 marks) ^[5]

c) Name the live-attenuated vaccines that must be withheld today, and the test that confirms or excludes a combined T-cell defect. (3 marks) ^{[1] [2]}

d) Outline the management of the inactivated vaccines in this infant while the defect is being characterised, and the role of the household. (3 marks) ^[2]