Live attenuated vaccines under immunosuppressive agents or biological agents: survey and clinical data from Japan.
Adverse events
Institutional research
Nationwide study
Patient research
Questionnaires
Vaccine-strain infections
Varicella
Journal
European journal of pediatrics
ISSN: 1432-1076
Titre abrégé: Eur J Pediatr
Pays: Germany
ID NLM: 7603873
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
27
07
2020
accepted:
01
01
2021
revised:
16
11
2020
pubmed:
2
2
2021
medline:
24
6
2021
entrez:
1
2
2021
Statut:
ppublish
Résumé
Live attenuated vaccines are contraindicated for patients on immunosuppressive agents or biological agent, except for live attenuated varicella vaccine, although previous reports showed their effectiveness and safety. This study is the nationwide cross-sectional research about the current utilization of live attenuated vaccines for patients on immunosuppressive agents or biological agents in Japan. We sent questionnaires to pediatric centers and examined whether each institution offered live attenuated vaccines to patients with immunosuppressive agents or biological agents (institutional research). We also examined adverse events associated with live attenuated vaccines between 2013 and 2017 (patient research). In the institutional research, 46 out of 334 institutions (13.8%) administered live attenuated vaccines to patients receiving immunosuppressive agents. In contrast, only six out of 270 institutions (2.2%) administered live attenuated vaccines to patients receiving biological agents. However, 66.3% of physicians answered that patients receiving immunosuppressive agents should be immunized with live attenuated vaccines, and only 7.0% disagreed with them. In the patient research, data for 781 patients were collected. Vaccine-associated infections were observed in only two patients (0.3%), both of whom had varicella, although they recovered promptly. No life-threatening adverse events were noted. In pediatric centers, the demand for live attenuated vaccines in patients receiving immunosuppressive agents was high and most physicians think they should be immunized. Immunization with live attenuated vaccines appeared safe in patients receiving immunosuppressive agents, although further studies are needed for patients receiving biological agents What is known: • Live attenuated vaccines (LAV) are generally contraindicated for patients on immunosuppressive agents (IS) or biological agents (BA), except for live attenuated varicella vaccine, as immunocompromised patients are at greater risk for serious viral infection from the vaccine strains. • Viral infections, such as measles and varicella, cause serious complications in children receiving IS. • Several previous reports showed that LAV is relatively effective and safe for patients receiving IS. What is new: • In Japan, the demand for LAV in patients receiving IS was high, and most physicians hoped they should be immunized. • Vaccine-associated infection is rarely observed in patients with IS after LAV administration. • Immunization with LAV appeared safe in patients receiving IS. University Hospital Medical Information Network (UMIN). UMIN000029176.Date of registration: 2017/09/19.
Identifiants
pubmed: 33523302
doi: 10.1007/s00431-021-03927-1
pii: 10.1007/s00431-021-03927-1
doi:
Substances chimiques
Biological Factors
0
Immunosuppressive Agents
0
Measles-Mumps-Rubella Vaccine
0
Vaccines, Attenuated
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1847-1854Subventions
Organisme : grants from the National Center for Child Health and Development
ID : 30-7
Organisme : the Japan Foundation for Pediatric Research
ID : 17-004
Références
Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M, Bousvaros A, Dhanireddy S, Sung L, Keyserling H, Kang I, Infectious Diseases Society of America (2014) 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis 58:e44–e100
Lynfield R, Herrin JT, Rubin RH (1992) Varicella in pediatric renal transplant recipients. Pediatrics 90:216–220
pubmed: 1322522
Broyer M, Tete MJ, Guest G, Gagnadoux MF, Rouzioux C (1997) Varicella and zoster in children after kidney transplantation: long-term results of vaccination. Pediatrics 99:35–39
doi: 10.1542/peds.99.1.35
Rand EB, McCarthy CA, Whitington PF (1993) Measles vaccination after orthotopic liver transplantation. J Pediatr 123:87–89
doi: 10.1016/S0022-3476(05)81545-8
Zamora I, Simon JM, Da Silva ME, Piqueras AI (1994) Attenuated varicella virus vaccine in children with renal transplants. Pediatr Nephrol 8:190–192
doi: 10.1007/BF00865476
Kano H, Mizuta K, Sakakihara Y, Kato H, Miki Y, Shibuya N, Saito M, Narita M, Kawarasaki H, Igarashi T, Hashizume K, Iwata T (2002) Efficacy and safety of immunization for pre- and post- liver transplant children. Transplantation 74:543–550
doi: 10.1097/00007890-200208270-00020
Chaves Tdo S, Lopes MH, de Souza VA, Dos Santos SS, Pereira LM, Reis AD, David-Neto E (2005) Seroprevalence of antibodies against varicella-zoster virus and response to the varicella vaccine in pediatric renal transplant patients. Pediatr Transplant 9:192–196
doi: 10.1111/j.1399-3046.2005.00279.x
Weinberg A, Horslen SP, Kaufman SS, Jesser R, Devoll-Zabrocki A, Fleckten BL, Kochanowicz S, Seipel KR, Levin MJ (2006) Safety and immunogenicity of varicella-zoster virus vaccine in pediatric liver and intestine transplant recipients. Am J Transplant 6:565–568
doi: 10.1111/j.1600-6143.2005.01210.x
Khan S, Erlichman J, Rand EB (2006) Live virus immunization after orthotopic liver transplantation. Pediatr Transplant 10:78–82
doi: 10.1111/j.1399-3046.2005.00403.x
Lu Y, Bousvaros A (2010) Varicella vaccination in children with inflammatory bowel disease receiving immunosuppressive therapy. J Pediatr Gastroenterol Nutr 50:562–565
doi: 10.1097/MPG.0b013e3181bab351
Posfay-Barbe KM, Pittet LF, Sottas C, Grillet S, Wildhaber BE, Rodriguez M, Kaiser L, Belli DC, McLin VA, Siegrist CA (2012) Varicella-zoster immunization in pediatric liver transplant recipients: safe and immunogenic. Am J Transplant 12:2974–2985
doi: 10.1111/j.1600-6143.2012.04273.x
Azevedo LS, Lasmar EP, Contieri FL, Boin I, Percegona L, Saber LT, Selistre LS, Netto MV, Moreira MC, Carvalho RM, Bruno RM, Ferreira TC, David-Neto E (2012) Yellow fever vaccination in organ transplanted patients: is it safe? A multicenter study. Transpl Infect Dis 14:237–241
doi: 10.1111/j.1399-3062.2011.00686.x
Kawano Y, Suzuki M, Kawada J, Kimura H, Kamei H, Ohnishi Y, Ono Y, Uchida H, Ogura Y, Ito Y (2015) Effectiveness and safety of immunization with live-attenuated and inactivated vaccines for pediatric liver transplantation recipients. Vaccine 33:1440–1445
doi: 10.1016/j.vaccine.2015.01.075
Shinjoh M, Miyairi I, Hoshino K, Takahashi T, Nakayama T (2008) Effective and safe immunizations with live-attenuated vaccines for children after living donor liver transplantation. Vaccine 26:6859–6863
doi: 10.1016/j.vaccine.2008.09.076
Shinjoh M, Hoshino K, Takahashi T, Nakayama T (2015) Updated data on effective and safe immunizations with live-attenuated vaccines for children after living donor liver transplantation. Vaccine 33:701–707
doi: 10.1016/j.vaccine.2014.11.052
Kamei K, Miyairi I, Ishikura K, Ogura M, Shoji K, Funaki T, Ito R, Arai K, Abe J, Kawai T, Onodera M, Ito S (2018) Prospective study of live attenuated vaccines for patients with nephrotic syndrome receiving immunosuppressive agents. J Pediatr 196:217–222
doi: 10.1016/j.jpeds.2017.12.061
Pittet LF, Verolet CM, McLin VA, Wildhaber BE, Rodriguez M, Cherpillod P, Kaiser L, Siegrist CA, Posfay-Barbe KM (2019) Multimodal safety assessment of measles-mumps-rubella vaccination after pediatric liver transplantation. Am J Transplant 19:844–854
doi: 10.1111/ajt.15101
Suresh S, Upton J, Green M, Pham-Huy A, Posfay-Barbe KM, Michaels MG, Top KA, Avitzur Y, Burton C, Chong PP, Danziger-Isakov L, Dipchand AI, Hébert D, Kumar D, Morris SK, Nalli N, Ng VL, Nicholas SK, Robinson JL, Solomon M, Tapiero B, Verma A, Walter JE, Allen UD (2019) Live vaccines after pediatric solid organ transplant: proceedings of a consensus meeting, 2018. Pediatr Transplant 23:e13571. https://doi.org/10.1111/petr.13571
doi: 10.1111/petr.13571
pubmed: 31497926
Campsall PA, Au NH, Prendiville JS, Speert DP, Tan R, Thomas EE (2004) Detection and genotyping of varicella-zoster virus by TaqMan allelic discrimination real-time PCR. J Clin Microbiol 42:1409–1413
doi: 10.1128/JCM.42.4.1409-1413.2004
Levitsky J, Te HS, Faust TW, Cohen SM (2002) Varicella infection following varicella vaccination in a liver transplant recipient. Am J Transplant 2:880–888
doi: 10.1034/j.1600-6143.2002.20912.x
Kraft JN, Shaw JC (2006) Varicella infection caused by Oka strain vaccine in a heart transplant recipient. Arch Dermatol 142:943–945
doi: 10.1001/archderm.142.7.943
Ortiz-Brizuela E, Leal-Vega F, Cuellar-Rodríguez J, Bobadilla-Del-Valle M, Ponce-de-León A (2019) Vaccine-derived varicella zoster infection in a kidney transplant recipient after zoster vaccine live administration. Vaccine 37:3576–3579
doi: 10.1016/j.vaccine.2019.05.017
Bobrowski AE, Muller WJ (2020) Varicella infection following vaccination in a pediatric kidney transplant recipient. Pediatr Transplant 24:e13667. https://doi.org/10.1111/petr.13667
doi: 10.1111/petr.13667
pubmed: 32068320