Medical Conditions – General (WIS)

Elderly

Very Young

Pregnant

Malnutrition and/or Malnourished

Have multi-organ failure

Severe Burns

Have invasive instruments in their bodies i.e. pacemakers, catheters

Have had recent surgery

Weak immune system conditions/disease

Catch or prone to infections easily

Unusual bleeding (nose, ears, eyes skin, gums, anus, genitals), bleeding into skin/prolonged bleeding after injury

Poor general health or of poor social wellbeing

Consume large amounts of alcohol

Heavy smoker (smoke more than 30 cigarettes daily, cigars, cigarillos, pipes or chew tobacco/beetle nut)

Stress

Long-term aspirin therapy in patients younger than 19 years

Medication and treatments:

• Those who are receiving or have received in the past 6 months of immunosurpressive therapy (including biologics), immunosupressive chemotherapy or radiotherapy for malignant and/or non- malignant disorders or have in the past 12 months recieved immunopsupressive therapy for sold organ transplant.
• Those who are receiving or have received in the past 12 months of biological therapy (i.e. anti-TNF therapy, such as alemtuzumab, ofatumumab, rituximab or similar).
• Those who have received  or have received in past 2 years Ocrelizumab or similar for multiple sclerosis.
• Those who are receiving high dose  corticosteroids, until at least 3 months after treatment has stopped inlcuding:
• Adults and children  on high dose corticosteroids (> 40mg prednisolone per day or 2mg/kg/day in children under 20kg) for more than one week.
• Adults and children  on a lower dose corticosteroids (> 20mg prednisolone per day or 1mg/kg/day in children under 20kg) for more than 14 days. Similar oral corticosteroids can cause systemic immunosupression.
• Please note non-systemic corticosteroids (i.e creams, inhalers or eye/ ear drops, suppositries) are not considered as systemic immunosurpression however it could potentially cause immunosurpression and this should be decided by healthcare professional before further treatment.
• Replacement corticosteroids for persons with adrenal insufficiency is not believed to cause immunosupression.
• For those taking or have until at least 6 months after termination such treatment of immunosupressant medication i.e methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide, tacrolimus, pimecrolimus, sirolimus, apremilast alone or in combination with a low dose corticosteroid.
• Always speak to a Healthcare Professional regarding the above as this list in not exhaustive.