Is anesthesia associated with impaired vaccine efficacy?

Vaccination and Anesthesia

Vaccines are broadly classified into two categories, that is, live attenuated (BCG, MMR) or inactivated (IPV).

Rash and fever are common 7–10 days after MMR, parotitis 3 weeks after MMR, and local reactions and fever within 48 h of DtaP/IPV/Hib.

In a survey of anaesthetists by Short and colleagues, 60% of the respondents stated that they would not delay anaesthesia for elective surgery in a recently immunized child, while 40% would postpone for a week for inactive vaccines and 3 weeks for live vaccine.

As a conclusion, misinterpretation of vaccine-related adverse events as postoperative complications may be avoided by respecting a minimal delay between immunization and anaesthesia.

A delay of 48 hours is needed for children immunized with inactivated vaccine. On the other hand, there is no need to delay anesthetic in a child immunized with live vaccine if the child is well at preoperative assessment.

The influence of anaesthesia on various markers of immunity has been assessed in children, showing a decrease in absolute T- and B-lymphocyte counts after surgery that return to preoperative values within hours or days. This may represent the redistribution of immune cells from the peripheral blood to lymphatic tissues or local sites of trauma rather than immunodepression. All studies demonstrate a short-lived and reversible influence on lymphoproliferative responses that return to preoperative values within 24-48 h.

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