Prospective study of live attenuated vaccines for patients receiving immunosuppressive agents.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
27
03
2020
accepted:
21
09
2020
entrez:
1
10
2020
pubmed:
2
10
2020
medline:
15
12
2020
Statut:
epublish
Résumé
Patients receiving immunosuppressive agents are at risk of life-threatening infections. However, live vaccines are generally contraindicated in them. We conducted a prospective study regarding live attenuated vaccines for them. Patients elder than one year of age with immunosuppressive agents who showed negative or borderline antibody titers (virus-specific IgG levels < 4.0) against one or more of measles, rubella, varicella, and mumps and fulfilled the criteria (CD4 cell counts ≥ 500/mm3, stimulation index of lymphocyte blast transformation by PHA ≥ 101.6, serum IgG level ≥ 300 mg/dl, no steroid use or prednisolone < 1 mg/kg/day or < 2 mg/kg/2 days, trough levels of tacrolimus or cyclosporine were < 10 ng/ml or < 100 ng/ml and under good control of primary disease) were enrolled. Sixty-four vaccinations were administered to 32 patients. The seroconversion rates for measles, rubella, varicella, and mumps were 80.0%, 100.0%, 59.1%, and 69.2%, respectively. No life-threatening adverse events were observed, although one patient suffered from vaccine-strain varicella who showed cellular and humoral immunodeficiency (CD4 cell counts = 511/mm3, stimulation index of lymphocyte blast transformation by PHA = 91.1, serum IgG level = 208 mg/dl). This girl was immunized before we established the criteria for vaccination. Immunization with live attenuated vaccines for patients receiving immunosuppressive agents might be effective and safe if their cellular and humoral immunological parameters are within normal levels. However, determining the criteria for vaccination by immunological parameters should be established to guarantee the safety of live vaccines in the future. Clinical Trial Registration: UMIN Clinical Trials Registry (UMIN-CTR) UMIN000007710. The date of registration: 2012/4/13.
Identifiants
pubmed: 33002085
doi: 10.1371/journal.pone.0240217
pii: PONE-D-20-06737
pmc: PMC7529194
doi:
Substances chimiques
Antibodies, Viral
0
Immunosuppressive Agents
0
Vaccines, Attenuated
0
Viral Vaccines
0
Banques de données
UMIN-CTR
['UMIN000007710']
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0240217Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Transpl Infect Dis. 2012 Jun;14(3):237-41
pubmed: 22093046
Transplantation. 2013 May 15;95(9):e59-61
pubmed: 23648410
Am J Transplant. 2012 Nov;12(11):2974-85
pubmed: 22994936
J Infect. 2012 Jun;64(6):543-54
pubmed: 22430715
Vaccine. 2008 Dec 9;26(52):6859-63
pubmed: 18930096
Arch Dermatol. 2006 Jul;142(7):943-5
pubmed: 16847227
Pediatr Nephrol. 1994 Apr;8(2):190-2
pubmed: 8018498
Pediatr Transplant. 2006 Feb;10(1):78-82
pubmed: 16499592
Am J Transplant. 2002 Oct;2(9):880-2
pubmed: 12392296
Pediatrics. 2007 Nov;120(5):e1345-9
pubmed: 17974726
J Pediatr. 1993 Jul;123(1):87-9
pubmed: 8320632
Vaccine. 2015 Jan 29;33(5):701-7
pubmed: 25510391
J Clin Microbiol. 2007 Sep;45(9):2902-8
pubmed: 17652480
Vaccine. 2015 Mar 17;33(12):1440-5
pubmed: 25665961
Pediatr Transplant. 2005 Apr;9(2):192-6
pubmed: 15787792
J Pediatr. 1994 Feb;124(2):273-6
pubmed: 8301437
Transplantation. 2002 Aug 27;74(4):543-50
pubmed: 12352917
J Clin Microbiol. 2004 Apr;42(4):1409-13
pubmed: 15070981
J Pediatr. 2018 May;196:217-222.e1
pubmed: 29499990
Am J Transplant. 2006 Mar;6(3):565-8
pubmed: 16468967