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Monogenic susceptibility to live viral vaccines

Lookup NU author(s): Dr Florian Gothe, Sophie Howarth, Dr Christopher DuncanORCiD, Professor Sophie HambletonORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021 The AuthorsLive attenuated viral vaccines (LAV) have saved millions of lives globally through their capacity to elicit strong, cross-reactive and enduring adaptive immune responses. However, LAV can also act as a Trojan horse to reveal inborn errors of immunity, thereby highlighting important protective elements of the healthy antiviral immune response. In the following article, we draw out these lessons by reviewing the spectrum of LAV-associated disease reported in a variety of inborn errors of immunity. We note the contrast between adaptive disorders, which predispose to both LAV and their wild type counterparts, and defects of innate immunity in which parenterally delivered LAV behave in a particularly threatening manner. Recognition of the underlying pathomechanisms can inform our approach to disease management and vaccination in a wider group of individuals, including those receiving immunomodulators that impact the relevant pathways.

Publication metadata

Author(s): Gothe F, Howarth S, Duncan CJ, Hambleton S

Publication type: Review

Publication status: Published

Journal: Current Opinion in Immunology

Year: 2021

Volume: 72

Pages: 167-175

Online publication date: 06/06/2021

Acceptance date: 02/04/2018

ISSN (print): 0952-7915

ISSN (electronic): 1879-0372

Publisher: Elsevier Ltd


DOI: 10.1016/j.coi.2021.05.006