Vaccination practices in pediatric transplantation: A survey among member centers of the European reference network TransplantChild
Daniele Donà, Luz Yadira Bravo‐Gallego, Esteban Frauca Remacha, Mara Cananzi, Andrea Gastaldi, Juan Torres Canizalez, Xavier Stephenne, Florence Lacaille, Caroline Lindemans, Elisabetta Calore, Nathalie Galea, Elisa Benetti, Edith Nachbaur, Ana Rita Sandes, Ana Teixeira, Sandra Ferreira, Maja Klaudel‐Dreszler, Oanez Ackermann, Olivia Boyer, Laura Espinosa, Luis García Guereta, Marco Sciveres, Björn Fischler, Nicolaus Schwerk, Mette Neland, Emanuele Nicastro, Luca Dello Strologo, Jacek Toporski, Inga Vainumae, Jelena Rascon, Vaidotas Urbonas, Teresa del Rosal, Eduardo López‐Granados, Giorgio Perilongo, Alastair Baker, Paloma Jara Vega, - Transplantation
- Pediatrics, Perinatology and Child Health
Abstract
Background
There is considerable variation in vaccination practices between pediatric transplant centers. This study aims to evaluate active immunization attitudes and practices among ERN‐TransplantChild centers and identify potential areas of improvement that could be addressed by shared evidence‐based protocols.
Methods
A cross‐sectional questionnaire of attitudes and practices toward immunization of pediatric SOT and HSCT candidates and recipients was sent to a representative member of multidisciplinary teams from 27 European centers belonging to the ERN‐TransplantChild.
Results
A total of 28/62 SOT programs and 6/12 HSCT programs across 21 European centers participated. A quarter of centers did not have an on‐site protocol for the immunizations. At the time of transplantation, pediatric candidates were fully immunized (80%–100%) in 57% and 33% of the SOT and HSCT programs. Variations in the time between vaccine administration and admission to the waiting list were reported between the centers, with 2 weeks for inactivated vaccines and variable time (2–4 weeks) for live‐attenuated vaccines (LAVs). Almost all sites recommended immunization in the post‐transplant period, with a time window of 4–8 months for the inactivated vaccines and 16–24 months for MMR and Varicella vaccines. Only five sites administer LAVs after transplantation, with seroconversion evaluated in 80% of cases.
Conclusions
The immunization coverage of European pediatric transplant recipients is still inconsistent and far from adequate. This survey is a starting point for developing shared evidence‐based immunization protocols for safe vaccination among pediatric transplant centers and generating new research studies.