Principles of immunisation in children with solid organ transplant. Issue 3 (16th September 2020)

• Record Type: Journal Article
• Authors: Kelgeri, Chayarani; Kelly, Dominic F; Brant, Alexandra; Patel, Mitul; Gupte, Girish L
• Is Part Of: Archives of disease in childhood. Volume 106:Issue 3(2021)
• Page Start: 219
• Page End: 223
• Publication Date: 2020-09-16
• Subjects: epidemiology -- therapeutics -- virology; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2020-319822
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Vaccine-preventable diseases (VPD) are a significant risk to paediatric solid organ transplant (SOT) recipients on lifelong immunosuppressive therapy. Children progressing to end-stage organ dysfunction are unable to mount a robust immune response. Hence, it is important to plan vaccination early in the course of disease, especially if a child is anticipated to be a SOT candidate. Vaccine recommendations need to be individualised in this population based on vaccine history and serology. Catch-up or accelerated schedules may be used to complete vaccinations before transplant. Post-transplant, immunisation is recommenced in consultation with the transplant team taking into context the time since transplant and the intensity of the immunosuppressive regime. Inactivated vaccines are safe post-transplant but postexposure prophylaxis may still be required in children with inadequate immunity to VPD. Specific vaccines may be advised for SOT recipients travelling abroad (in consultation with a travel clinic) or those entering high-risk professions. Additionally, the vaccination status of all household members and close contacts should be reviewed and optimised, offering additional protection to the transplant recipient.