Should Kids Taking Immunosuppressant Medication Receive the H1N1 Vaccine?

October 30, 2009

The Centers for Disease Control and Prevention (CDC) have classified all children, 6-months to 24-years, one of the high risk groups for contracting the H1N1 (swine) flu, and recommend this population receive the H1N1 vaccine for immunity against the disease. But what about the millions of children who are already battling other diseases – chronic diseases including asthma, rheumatoid arthritis, HIV, irritable bowel disease (IBD) and other digestive disorders such as Crohn’s disease? Is it safe for these kids to receive the H1N1 vaccine when already taking an immunosuppressant – medication that weakens the immune system but controls their disease? Will mixing the H1N1 vaccine with these powerful medications put the patient at an even greater risk?

Doctors at Nationwide Children’s Hospital in Columbus, Ohio have been tackling this question from not just a few parents, but from a number of concerned parents. During the past five years there has been an explosion of new immunosuppressant medications, and it’s estimated that nearly 5 million children are currently taking these prescriptions to control their chronic conditions.

“It is extremely important that they [patients on immunosuppressant medication] get the H1N1 vaccine and receive it in the form of a shot, rather than in the form of a mist,” explained Dennis Cunningham, MD, an infectious disease physician and medical director of Epidemiology at Nationwide Children’s Hospital. “The reason we recommend the shot is because the mist is a live virus, and we do not want kids whose immune system is already weak to receive a live virus. Immunity to the H1N1 flu, among other diseases, is very important for kids with chronic conditions.”

Dr. Cunningham, who is leading the H1N1 efforts at Nationwide Children’s, says that it’s not an 100 percent guarantee these patients battling chronic conditions will not contract the H1N1 virus just by receiving immunization. He also suggests additional protection through what’s called ring vaccination. The idea is to make sure there is a barrier of protection for all family members that are in direct and frequent contact with children taking immunosuppressant medication.

“It’s also important for parents to put another layer of protection around their child and do so by making sure parents themselves and other children in the home receive the vaccine,” said Dr. Cunningham, also on the faculty at The Ohio State University College of Medicine.

The caveat is that there is no assurance others outside the home will be vaccinated. Important measures like washing your hands, covering your cough and sneeze with your elbow, getting adequate amounts of sleep and plenty of fluids, and staying home from work or school when sick, are stressed and should be followed. Parents should always consult their child’s pediatrician or primary care physician first for any and all questions about what’s right for the child’s health care needs.

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2019-20 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric health care systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of more than 13,000 providing state-of-the-art pediatric care during more than 1.5 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at