{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T21:35:01Z","timestamp":1783373701774,"version":"3.54.6"},"reference-count":40,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE:<\/jats:title>\n                  <jats:p>Live vaccines are generally contraindicated in patients with DiGeorge syndrome (DGS), a congenital disorder characterized by cellular immune deficiency. Vaccine utilization and safety in this population are not well described. This study examined vaccination patterns and adverse events following live immunization (AEFLI) in these individuals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>A multicenter retrospective cohort study was conducted in subjects with DGS confirmed by fluorescence in situ hybridization assay (chromosome 22q11.2 microdeletion). Live vaccine-preventable illnesses, vaccination coverage and timeliness, and AEFLIs in the 56-day window after live vaccination were examined. Bivariate and multivariable analyses assessed the impact of demographics medical history, timing of diagnostic confirmation, and preceding immune function on vaccination patterns and AEFLIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Of 194 subjects, 77% and 75% received measles-mumps-rubella (MMR) and varicella vaccines, respectively; 58% completed recommended vaccinations by age 19 to 35 months. Adverse events occurred after 14% and 20% of MMR and varicella vaccine doses, respectively. Most events were minor, few were serious, and no deaths were reported in post\u2013live vaccination windows. Although early diagnostic confirmation negatively affected live vaccination coverage and timeliness (P &amp;lt; .001), baseline CD4% did not differ between subjects who did or did not receive live vaccines by 12 to 18 months. Among varicella vaccine recipients, those with a subsequent adverse event had a lower preceding CD4% (24.8% \u00b1 7.3%) than those without (35.5% \u00b1 11.7%) (P &amp;lt; .05); no CD4% differences were observed with MMR vaccination. Fourteen unvaccinated subjects experienced live vaccine\u2013preventable illnesses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Live vaccines were frequently given and generally well-tolerated among patients with DGS with mild-to-moderate immunosuppression.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2013-0831","type":"journal-article","created":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T02:37:54Z","timestamp":1396319874000},"page":"e946-e954","source":"Crossref","is-referenced-by-count":37,"title":["Live Vaccine Use and Safety in DiGeorge Syndrome"],"prefix":"10.1542","volume":"133","author":[{"given":"Annika M.","family":"Hofstetter","sequence":"first","affiliation":[{"name":"Divisions of Child and Adolescent Health, and"},{"name":"NewYork-Presbyterian\/Morgan Stanley Children\u2019s Hospital, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Jakob","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases, Department of Pediatrics, Columbia University, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola P.","family":"Klein","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Vaccine Study Center, Oakland, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia L.","family":"Dekker","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn M.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Vanderbilt Vaccine Research Program, Vanderbilt University Medical Center, Nashville, Tennessee; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal A.","family":"Halsey","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Institute for Vaccine Safety, Department of International Health, Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Baxter","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Vaccine Study Center, Oakland, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Elizabeth","family":"Williams","sequence":"additional","affiliation":[{"name":"Vanderbilt Vaccine Research Program, Vanderbilt University Medical Center, Nashville, Tennessee; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Philip L.","family":"Graham","sequence":"additional","affiliation":[{"name":"NewYork-Presbyterian\/Morgan Stanley Children\u2019s Hospital, New York, New York;"},{"name":"Pediatric Infectious Diseases, Department of Pediatrics, Columbia University, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"LaRussa","sequence":"additional","affiliation":[{"name":"NewYork-Presbyterian\/Morgan Stanley Children\u2019s Hospital, New York, New York;"},{"name":"Pediatric Infectious Diseases, Department of Pediatrics, Columbia University, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2014,4,1]]},"reference":[{"issue":"1 pt 1","key":"2021120903200258300_B1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1542\/peds.112.1.101","article-title":"A population-based study of the 22q11.2 deletion: phenotype, incidence, and contribution to major birth defects in the population.","volume":"112","author":"Botto","year":"2003","journal-title":"Pediatrics"},{"issue":"9","key":"2021120903200258300_B2","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1136\/jmg.35.9.789-a","article-title":"The annual incidence of DiGeorge\/velocardiofacial syndrome.","volume":"35","author":"Devriendt","year":"1998","journal-title":"J Med Genet"},{"key":"2021120903200258300_B3","first-page":"A169","article-title":"Minimum prevalence of chromosome 22q11 deletions.","volume":"55","author":"Wilson","year":"1994","journal-title":"Am J Hum 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Pediatr"},{"issue":"5","key":"2021120903200258300_B7","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1067\/mpd.2001.118534","article-title":"Immunologic features of chromosome 22q11.2 deletion syndrome (DiGeorge syndrome\/velocardiofacial syndrome).","volume":"139","author":"Jawad","year":"2001","journal-title":"J Pediatr"},{"issue":"6","key":"2021120903200258300_B8","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1007\/s10875-011-9569-8","article-title":"A prospective study of influenza vaccination and a comparison of immunologic parameters in children and adults with chromosome 22q11.2 deletion syndrome (DiGeorge syndrome\/velocardiofacial syndrome).","volume":"31","author":"Jawad","year":"2011","journal-title":"J Clin Immunol"},{"issue":"10","key":"2021120903200258300_B9","doi-asserted-by":"crossref","first-page":"4539","DOI":"10.1182\/blood-2006-10-048652","article-title":"Review of 54 patients with complete DiGeorge anomaly enrolled in protocols for thymus 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immunizations.","volume":"30","author":"Halsey","year":"2012","journal-title":"Vaccine"},{"issue":"32","key":"2021120903200258300_B19","doi-asserted-by":"crossref","first-page":"4278","DOI":"10.1016\/j.vaccine.2009.05.023","article-title":"Serious adverse events rarely reported after trivalent inactivated influenza vaccine (TIV) in children 6\u201323 months of age.","volume":"27","author":"Rosenberg","year":"2009","journal-title":"Vaccine"},{"issue":"50","key":"2021120903200258300_B20","doi-asserted-by":"crossref","first-page":"7253","DOI":"10.1016\/j.vaccine.2012.09.074","article-title":"Causality assessment of adverse events reported to the Vaccine Adverse Event Reporting System (VAERS).","volume":"30","author":"Loughlin","year":"2012","journal-title":"Vaccine"},{"key":"2021120903200258300_B21","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1542\/peds.2010-1722J","article-title":"Understanding the role of human variation in vaccine adverse events: the Clinical Immunization 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