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Vaccinations are important to protect us against infection and disease – but they are also confusing.
Some vaccines are “live,” some are “attenuated (killed),” some protect against viral infections, some protect against bacterial infections, some are given only in childhood, some need a “booster” later in life, some are only given later in life. Adding Duchenne – medications, pulmonary, and cardiac function – to the picture adds even more confusion.
The recommendations below should help to answer the regularly asked questions, “to give or not to give, when to give, how to give and what to give.”
Please bring your vaccination record to your annual appointment, and provide this information to your general pediatrician.
General Vaccination Recommendations for People Living with Duchenne
The use of corticosteroids (prednisone or deflazacort) should be discussed with the parent of every child living with Duchenne by age 3yo (or as soon as possible after receiving a diagnosis). Long-term daily corticosteroid use may cause some degree of immunosuppression and may increase the risk of infections. It is best to discuss the full vaccine schedule with your medical providers prior to the start of corticosteroid treatment.
If possible, childhood vaccinations should be completed prior to the start of daily corticosteroid therapy.
"LIVE" Vaccine Precautions:
If vaccinations are not complete prior to starting corticosteroids, the Centers for Disease Control and Prevention (CDC) report that:
We realize that this is a change and contradicts what has been reported in the past. We do continue to recommend that live virus vaccines be given before daily corticosteroids are started, when possible, and that live virus vaccines be avoided when possible (i.e., people with Duchenne should receive the “flu shot” [not a live virus vaccine] rather than the “nasal spray” [live virus] annually).
Protects against measles, mumps, and rubella.
Protects against Chicken pox.
Annual Flu Vaccine:
Protects against prevalent yearly strains of influenza.
Tdap (tetanus), Hep B (hepatitis B), Inactivated Polio, Meningococcal conjugate vaccine, HPV (human papilloma virus vaccine)
CDC webpage is an excellent source of information on the usual safety issues, frequency of administration, etc: CDC - Immunization Schedules
The recommendations in this summary are consistent with recommendations from the AAP Redbook Committee and CDC’s Advisory Committee on Immunization Practices, and were made in consultation between the UCLA Pediatric Infectious Disease Division and the Pediatric Neuromuscular Team of the Center for Duchenne Muscular Dystrophy at UCLA and the CDC.
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