A young girl has had repeated infections with Candida albicans and respiratory viruses since she was 3 months old. As part of the clinical evaluation of her immune status, her responses to routine immunization procedures should be tested. In this evaluation, the use of which of the following vaccines is contraindicated?
High-Yield Explanation
Recurrent severe infection is an indication for clinical evaluation of immune status. Live vaccines, including BCG attenuated from M. tuberculosis, should not be used in the evaluation of a patient's immune competence because patients with severe immunodeficiencies may develop an overwhelming infection (disseminated disease) from the vaccine. For the same reason, oral (Sabin) polio vaccine is not advisable for use in such persons. The other vaccines listed are acellular and should be safe to use in this clinical scenario described.