Vaccination after Intravenous Immunoglobulin Treatment in Children with Kawasaki Disease

Children with Kawasaki disease (KD) receive intravenous immunoglobulin (IVIG) for treatment. IVIG is a polyclonal immunoglobulin purified from plasma of blood donors. There are concerns that these passively acquired antibodies may interfere with the immune response to vaccination. In this study, the authors describe the basic principles of vaccination after IVIG treatment in children with KD. The in vivo half-life of IVIG depends on the type, dose, and administration method of IVIG, as well as the age, gender, and race of the host. IVIG does not interfere with immunogenicity of inactivated vaccines but does interfere with live attenuated vaccines (LAV). Therefore, in Korea, it is recommended to receive measles or varicella vaccine 11 months after high-dose IVIG treatment. However, in Japan and some European countries, a shorter interval between IVIG treatment and LAV vaccination is recommended. Because the manufacturers and race affect the immune responses and half-life of IVIG, clinical trials targeting Korean KD patients are needed.