Vaccines in sickle cell disease

Patients suffering from sickle cell disease are prone to bacterial infections, due to anatomic or functional asplenia. Active immunization against several pathogens is essential in the management of such patients. Children, adolescents and adults with sickle cell disease should be vaccinated with all the vaccines included in the National Immunization Program. Moreover, they should also be vaccinated against polysaccharide encapsulated bacteria (N. meningitidis, H. influenza type b, and Streptococcus pneumoniae) because of their impaired immunity against those organisms. These patients are considered a high risk group for acquiring viral blood borne infections via blood transfusion, and should be vaccinated against hepatitis B virus, and they should be vaccinated each year against the influenza virus due to the risk of developing severe pulmonary bacterial infections during the course of an influenza virus infection. This article comprises updated information about active immunization in patients with sickle cell disease, including indications, contraindications, adverse reactions, effectiveness and a vaccination timetable for this particular group of patients.