Vaccines and Immunization
Infectious diseases cause a substantial burden of disease in patients with chronic illness. Although safe and effective vaccines are available to reduce this disease burden, vaccine coverage in patients with chronic illness is often sub-optimal. The classes of vaccines include live attenuated vaccines and inactivated vaccines. Primary care physicians and other care providers should be familiar with national vaccination guidelines for those with chronic diseases and offer appropriate vaccination for this high-risk group. Principles of vaccination in patients with chronic diseases include avoiding live vaccines for patients with most immunocompromising conditions, offering appropriate vaccination to close contacts, and providing vaccines early in the course of illness, when vaccine-elicited immune responses are still robust. Barriers to vaccine uptake include difficulties in access and acceptance; vaccine hesitancy is a difficult problem for medical providers.
