Vaccination practices in pediatric transplantation: A survey among member centers of the European reference network TransplantChild.

children immunosuppression transplant vaccination vaccine-preventable infections

Journal

Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574

Informations de publication

Date de publication:
Nov 2023
Historique:
revised: 24 04 2023
received: 08 03 2022
accepted: 16 07 2023
pubmed: 6 8 2023
medline: 6 8 2023
entrez: 6 8 2023
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 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.

Identifiants

DOI: 10.1111/petr.14589 PMID: 37543721
pubmed: 37543721
doi: 10.1111/petr.14589
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e14589

Subventions

Organisme : European Reference Network on pediatric Transplantation (ERN TransplantChild)
Organisme : European Union

Informations de copyright

© 2023 The Authors. Pediatric Transplantation published by Wiley Periodicals LLC.

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Auteurs

Daniele Donà (D)

Division of Pediatric Infectious Diseases, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy.
ORCID: 0000-0001-7105-2105

Luz Yadira Bravo-Gallego (LY)

Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute of Biomedical Research (IdiPAZ), Center for Biomedical Network Research on Rare Diseases (CIBERER U767), Madrid, Spain.
ORCID: 0000-0002-4919-5166

Esteban Frauca Remacha (EF)

Pediatric Hepatology Department, La Paz University Hospital, Molecular Hepatology Group, La Paz Institute of Biomedical Research (IdiPAZ), Madrid, Spain.

Mara Cananzi (M)

Unit of Paediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy.

Andrea Gastaldi (A)

Division of Pediatric Infectious Diseases, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy.
Department of Pediatrics, Woman and Child Hospital, University of Verona, Verona, Italy.

Juan Torres Canizalez (JT)

Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute of Biomedical Research (IdiPAZ), Center for Biomedical Network Research on Rare Diseases (CIBERER U767), Madrid, Spain.

Xavier Stephenne (X)

Laboratoire d'Hépatologie Pédiatrique et Thérapie Cellulaire, Unité PEDI, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain (UCLouvain), Brussels, Belgium.

Florence Lacaille (F)

Service de Gastroentérologie-Hépatologie-Nutrition Pédiatriques, Hôpital Necker-Enfants Malades, AP-HP, Université Paris Descartes, Paris, France.

Caroline Lindemans (C)

Princess Maxima Center for Pediatric Oncology, Pediatric Blood and Marrow Transplantation Program, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Elisabetta Calore (E)

Pediatric Hematology, Oncology and Stem Cell Transplant Division, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy.

Nathalie Galea (N)

Paediatric Department of Mater Dei Hospital, Msida, Malta.

Elisa Benetti (E)

Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, Azienda Ospedaliera di Padova, Padua, Italy.

Edith Nachbaur (E)

Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.

Ana Rita Sandes (AR)

Unidade de Nefrologia e Transplantação Renal, Serviço de Pediatria Médica, Departamento de Pediatria, Hospital de Santa Maria, Centro Académico de Medicina, Universidade de Lisboa, Lisbon, Portugal.

Ana Teixeira (A)

Department of Pediatric Nephrology, Pediatric Service, Centro Materno-Infantil do Norte, Centro Hospitalar do Porto, Porto, Portugal.

Sandra Ferreira (S)

Hepatology and Pediatric Liver Transplantation Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Maja Klaudel-Dreszler (M)

Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland.

Oanez Ackermann (O)

Hepatologie et Transplantation Hepatique Pediatriques, Centre de reference de l'atresie des voies biliaires et des cholestases genetiques, FSMR FILFOIE, ERN RARE LIVER, Hôpital Bicêtre, AP-HP, Université Paris-Saclay, Le Kremlin-Bicêtre, France.

Olivia Boyer (O)

Service de Néphrologie Pédiatrique, AP-HP, Centre de Référence de maladies rénales rares de l'enfant et de l'adulte (MARHEA), Hôpital Necker-Enfants Malades, Paris, France.
Institut Imagine, Laboratoire des maladies rénales héréditaires, INSERM UMR 1163, Université de Paris, Paris, France.
ORCID: 0000-0002-3957-1359

Laura Espinosa (L)

Pediatric Nephrology Department, La Paz University Hospital, Diagnosis and Treatment of Diseases Associated with Abnormalities of the Complement System Group, La Paz Institute of Biomedical Research (IdiPAZ), Madrid, Spain.

Luis García Guereta (LG)

Pediatric Cardiology Department, La Paz University Hospital, Madrid, Spain.

Marco Sciveres (M)

Pediatric Hepatology and Liver Transplantation, ISMETT-University of Pittsburgh Medical Center Italy, Palermo, Italy.

Björn Fischler (B)

Department of Pediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet, Stockholm, Sweden.

Nicolaus Schwerk (N)

Paediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Hannover, Germany.

Mette Neland (M)

Department of Paediatrics and Adolescence Medicine, Odense University Hospital, Odense, Denmark.

Emanuele Nicastro (E)

Pediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, Bergamo, Italy.

Luca Dello Strologo (L)

Nephrology Unit, Bambino Gesù Children's Research Hospital, IRCCS, Rome, Italy.
ORCID: 0000-0002-8237-852X

Jacek Toporski (J)

Department of Pediatrics, Section of Pediatric Oncology, Hematology, Immunology and Nephrology, Skåne University Hospital, Lund, Sweden.
Center of Allogenic Stem Cell Transplantation and Cellular Therapy, Karolinska University Hospital, Stockholm, Sweden.
ORCID: 0000-0001-6012-0651

Inga Vainumae (I)

Department of Pediatrics, Tartu University Hospital, Tartu, Estonia.

Jelena Rascon (J)

Centre for Paediatric Oncology and Haematology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
ORCID: 0000-0003-4420-6943

Vaidotas Urbonas (V)

Department of Paediatric Gastroenterology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.

Teresa Del Rosal (T)

Paediatric Infectious and Tropical Diseases Department, La Paz University Hospital, Translational Research Network in Paediatric Infectious Diseases (RITIP), La Paz Institute of Biomedical Research (IdiPAZ), and Center for Biomedical Network Research on Rare Diseases (CIBERER U767), Madrid, Spain.

Eduardo López-Granados (E)

Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute of Biomedical Research (IdiPAZ), Center for Biomedical Network Research on Rare Diseases (CIBERER U767), Madrid, Spain.
Clinical Immunology Department, La Paz University Hospital, Madrid, Spain.

Giorgio Perilongo (G)

Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy.

Alastair Baker (A)

Paediatric Liver, Gastrointestinal and Nutrition Centre, King's College London School of Medicine at King's College Hospital, London, UK.

Paloma Jara Vega (PJ)

Pediatric Hepatology Department, La Paz University Hospital, Molecular Hepatology Group, La Paz Institute of Biomedical Research (IdiPAZ), ERN TransplantChild Coordinator, Madrid, Spain.

Classifications MeSH