Individuals with a complete absence of B cells and antibodies, such as patients with XLA, show a limited range of susceptibilities to infection rather than a global immunodeficiency to all categories of pathogens. For example, XLA patients show increased susceptibility to pyogenic bacterial infections, as antibody binding to these microbes is critical for their uptake and destruction by phagocytes. Clinicians caring for these patients are advised regarding their vaccinations, some of which could be highly dangerous to the antibody-deficient patient. In particular, XLA patients should never receive:
A) The tetanus toxoid vaccine composed of the inactivated toxin protein
B) The pneumococcal vaccine composed of polysaccharide antigens from 9 strains of Streptococcus pneumoniae
C) The influenza vaccine, composed of inactivated influenza virus
D) The Hib vaccine, composed of Haemophilus influenzae type b polysaccharides conjugated to the tetanus toxoid protein
E) The live oral polio vaccine, composed of an attenuated strain of the enteric poliovirus
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