Clinical Scenario:
A 5-year-old boy with steroid-dependent nephrotic syndrome is receiving prednisolone (1 mg/kg alternate days) and tacrolimus. He has completed all vaccinations according to the Pakistan EPI schedule. He has never had chickenpox. His parents ask whether he should receive the varicella vaccine.
What is the most appropriate advice?
A. Give varicella vaccine
B. Give VZIG
C. Defer vaccination
D. Stop tacrolimus
E. Repeat MR vaccine
Correct Answer & Explanation:
Correct answer: C Defer vaccination
Explanation
Varicella vaccine is a live attenuated vaccine and should not be administered to children receiving significant immunosuppressive therapy such as tacrolimus. Vaccination should be deferred until immunosuppressive therapy has been discontinued for the recommended interval and immune function has recovered.
