Patients with significant immunodeficiency, defined as <600 CD3+ cells/mm^3, should avoid unnecessary exposure to infectious people and should avoid live virus vaccines.[105]Waters V, Peterson KS, LaRussa P. Live viral vaccines in a DiGeorge syndrome patient. Arch Dis Child. 2007;92:519-520.
http://www.ncbi.nlm.nih.gov/pubmed/16798784?tool=bestpractice.com
However, most patients who have T-cell counts >600 cells/mm^3 can safely receive these vaccines.[99]Moylett EH, Wasan AN, Noroski LM, et al. Live viral vaccines in patients with partial DiGeorge syndrome: clinical experience and cellular immunity. Clin Immunol. 2004;112:106-112.
http://www.ncbi.nlm.nih.gov/pubmed/15207787?tool=bestpractice.com
[100]Perez EE, Bokszczanin A, McDonald-McGinn D, et al. Safety of live viral vaccines in patients with chromosome 22q11.2 deletion syndrome (DiGeorge syndrome/velocardiofacial syndrome). Pediatrics. 2003;112:e325.
http://pediatrics.aappublications.org/cgi/content/full/112/4/e325
http://www.ncbi.nlm.nih.gov/pubmed/14523220?tool=bestpractice.com
[101]Chinen J, Rosenblatt HM, Smith EO, et al. Long-term assessment of T-cell populations in DiGeorge syndrome. J Allergy Clin Immunol. 2003;111:573-579.
http://www.ncbi.nlm.nih.gov/pubmed/12642839?tool=bestpractice.com
[102]Davis CM, Kancherla VS, Reddy A, et al. Development of specific T-cell responses to Candida and tetanus antigens in partial DiGeorge syndrome. J Allergy Clin Immunol. 2008;122:1194-1199.
http://www.ncbi.nlm.nih.gov/pubmed/18789819?tool=bestpractice.com
[103]Azzari C, Gamineri E, Resti M, et al. Safety and immunogenicity of measles-mumps-rubella vaccine in children with congenital immunodeficiency (DiGeorge syndrome). Vaccine. 2005;23:1668-1671.
http://www.ncbi.nlm.nih.gov/pubmed/15705470?tool=bestpractice.com
[104]Sullivan KE. Live viral vaccines in patients with DiGeorge syndrome. Clin Immunol. 2004;113:3.
http://www.ncbi.nlm.nih.gov/pubmed/15380522?tool=bestpractice.com
[115]Al-Sukaiti N, Reid B, Lavi S, et al. Safety and efficacy of measles, mumps, and rubella vaccine in patients with DiGeorge syndrome. J Allergy Clin Immunol. 2010;126:868-869.
http://www.ncbi.nlm.nih.gov/pubmed/20810153?tool=bestpractice.com
Patients with significant immunodeficiency should also be aware of the need to present early to the physician with any fever or other signs of illness.
Awareness of the potential for specific learning disorders can help parents intervene early with requests for individualized education plans for their children.
Patients should also be aware of the recurrence risk in their children. Half of their offspring would be expected to have the disorder, and the severity may be worse in their children.