So with my DD, she is not immuno-compromised. The issue with her and with other heart babies is that if they get sick, they get sicker than a heart-normal baby would get. So protecting her from getting sick is our big focus. That was one of my big issues with the Prevnar13 shot because fever spikes are specifically called out on the CDC handout but I'm told over and over again that it's a problem if DD gets a fever. Now, one of her cardiologists said there is a difference between a vaccine fever and a fever from a virus or bacteria and I get that but when she gets a fever, we don't know right away what's causing it. So we have to do a full workup rather than just going "Oh it's probably from the vaccine she got the other day.". Also, with heart babies, it is a big deal to keep them away from respiratory illnesses. Hence the RSV shot (which isn't a vaccine in the true sense).
For me, I had to make the decision on whether or not I could live with myself if DD got sick from a vaccine-preventable disease or illness and died. Because in her situation, death is a likely result. The week DD was in the PICU, I watched the family of a 7 month old little boy who also had Tetralogy of Fallot with Pulmonary Atresia gather together as they made the decision to turn off the ECMO machine that he was hooked up to and let him die. I passed the mom and dad in the hallway as they walked away from the PICU for the last time with the few worldly possessions that had belonged to their son clutched in their arms. I had spoken to the mom a few times and she told me some of her son's history. He was repeatedly sick from the time he went home the first time from the hospital with various respiratory illnesses. It weakened his body and he was not able to make it through the major repair surgery. I don't know what his vaccine history was.
I do take precautions that her doctors think are unnecessary like splitting the vaccines up. But they don't give me a hard time about it. We don't have to do Hep B until it's time for DD to start school. And I won't be doing the variacella vaccine. I'll probably delay the MMR until after she's two at least if I do it at all.
I take other precautions that some would consider unnecessary. I give her probiotics and vitamin D daily. Based on my research, that's one of the best ways to keep her immune system functioning at it's highest level. I can't keep DD in a bubble. I can't keep her older siblings away from her. They attend school and they have four younger siblings at their mom's house who are frequently sick. DSD 12 has acquired her yearly winter lingering cough/lung issue. I wish that I could keep them healthy but their mom doesn't buy in to the probiotics and vitamin D so they get sick. DD's stomach bug that landed us in the hospital came from them. It happens. BUT, I don't go overboard with antibacterial stuff which my mom disagrees with. I wash my hands with regular soap. I don't make the kids use hand sanitizer. I don't freak out if DD's pacifier falls on the floor. I wash it off if I'm near water but if not, I just wipe it. I think it's important to get natural immunity from the germs that are always around us. I let other people hold her when we are out but I make sure to wash her hands or give her bath when we get home.