Table 2.

Categories of immunocompromise based on type of immune suppression

Category	Description
1. Diseases without immune compromise	HIV with CD4 ≥500/mm3 Malignancy with chemotherapy ≥3 months ago and in remission SOT or BMT ≥2 years with no immunosuppressive treatment and no GVHD Corticosteroids ≤20 mg of prednisone or equivalent for ≤2 weeks; inhaled or topical corticosteroid use Autoimmune disease without treatment Multiple sclerosis with no exacerbations and no treatment
2. Diseases and therapies with limited immune compromise	HIV with CD4 200–500/mm3 Complement deficiencies Anatomic or functional asplenia Diabetes mellitus Chronic renal disease Chronic liver disease Multiple sclerosis with exacerbation but not on treatment Nutritional deficiencies
3. Diseases and therapies with severe immune compromise	HIV with CD4 ≤200/mm3 (or CD4 percentage <15) BMT ≤2 years or on immunosuppressive treatment or with GVHD SOT ≤1 year or on immunosuppressive treatment or with GVHD Treatment for rejection after SOT Active hematologic or generalized malignancies Chronic lymphocytic leukemia Recent radiation therapy Aplastic anemia Congenital immunodeficiency Prednisone (or corticosteroid equivalent) ≥2 mg/kg of body weight per day or ≥20 mg of daily prednisone or equivalent in those ≥10 kg for a duration of ≥2 weeks Medications: alkylating agents, antimetabolites, chemotherapeutics, immunomodulators, or TNF blockers Thymus disorder (in the case of yellow fever vaccination)

Note: Copyright © 2014. Adapted from Kotton CN, Freedman DO. Advising Travelers With Specific Needs:Immunocompromised Traveler. Chapter 8: The Yellow Book; 2014. Available from: http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-8-advising-travelers-with-specific-needs/immunocompromised-travelers.48

Abbreviations: BMT, bone marrow transplant; GVHD, graft-versus-host disease; HIV, human immunodeficiency virus; SOT, solid organ transplant; TNF, tumor necrosis factor.