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Question 1: Do children with Down syndrome benefit from extra vaccinations?
  1. Dean Huggard1,
  2. Eleanor J Molloy1,2,3,4
  1. 1 Discipline of Paediatrics, University of Dublin, Trinity College, Dublin, Ireland
  2. 2 Paediatrics, Tallaght Hospital, Dublin, Ireland
  3. 3 Neonatology, Our Lady’s Children’s Hospital, Dublin, Ireland
  4. 4 Neonatology, Coombe Women’s and Infants University Hospital, Dublin, Ireland
  1. Correspondence to Professor Eleanor J Molloy, Department of Paediatrics, Department of Paediatrics, Trinity Centre for Health Sciences, Tallaght Hospital, Dublin 24, Ireland; elesean{at}

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A 4-month-old baby girl with Down syndrome (DS) attended the General Paediatric clinic for routine follow-up. She had commenced her routine vaccination schedule. The Registrar asked, as children with DS are at increased risk of infections, should this baby have any extra vaccinations?

Structured clinical question

In children with DS (population), do additional booster vaccinations (intervention) as well as routine improve outcome (outcome)?

Search strategy

Primary sources

MEDLINE was searched via PubMed up to January 2018; the advanced search mode was used including the terms ‘Down syndrome’ or ‘Trisomy 21’ and ‘immunisation’ or ‘vaccination’ or ‘booster immunisation’ or ‘booster vaccination’ or ‘antibody titres’ or ‘antibody response or ‘vaccine titre’ or ‘vaccine response’. The articles were selected based on the ‘most relevant’ search mode.

Secondary sources

A search of the Cochrane Library using the search terms ‘Down syndrome’, ‘Trisomy 21’, ‘vaccinations’ and ‘immunisations’ were performed. No significant results were found.



Children with DS are at increased risk of infections such as pneumonia and mortality from sepsis secondary to altered immune function. In DS, there are reduced numbers of T and B lymphocytes, a dysregulation of cytokines and often a suboptimal antibody response to vaccination.1 Furthermore, there is a defect in the generation and …

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  • Contributors DH was the lead author and contributed to the main body of this manuscript. EJM provided review and editorial guidance.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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