Immunizations in solid organ and hematopoeitic stem cell transplant patients: A comprehensive review

Hum Vaccin Immunother. 2015;11(12):2852-63. doi: 10.1080/21645515.2015.1078043.

Abstract

The Solid Organ Transplantation (SOT) and Haematopoietic Stem Cell Transplantation (HSCT) population is continuously increasing as a result of broader indications for transplant and improved survival. Infectious diseases, including vaccine-preventable diseases, are a significant threat for this population, primarily after but also prior to transplantation. As a consequence, clinicians must ensure that patients are optimally immunized before transplantation, to provide the best protection during the early post-transplantation period, when immunosuppression is the strongest and vaccine responses are poor. After 3-6 months, inactivated vaccines immunization can be resumed. By contrast, live-attenuated vaccines are lifelong contraindicated in SOT patients, but can be considered in HSCT patients at least 2 years after transplantation, if there is no immunosuppression or graft-versus-host-disease. However, because of the advantages of live-attenuated over inactivated vaccines--and also sometimes the absence of an inactivated alternative--an increasing number of prospective studies on live vaccine immunization after transplantation are performed and give new insights about safety and immunogenicity in this population.

Keywords: Haematopoietic stem cell transplantation; graft versus host disease; immunogenicity; immunosuppression; safety; serology; solid organ transplantation; vaccine.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Graft vs Host Disease / immunology
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunosuppression Therapy*
  • Organ Transplantation*
  • Transplant Recipients*
  • Vaccination*
  • Vaccines, Attenuated / immunology
  • Vaccines, Inactivated / immunology
  • Viral Vaccines / immunology

Substances

  • Vaccines, Attenuated
  • Vaccines, Inactivated
  • Viral Vaccines