Live vaccines after pediatric solid organ transplant: Proceedings of a consensus meeting, 2018

Sneha Suresh, Julia Upton, Michael Green, Anne Pham-Huy, Klara M. Posfay-Barbe, Marian G. Michaels, Karina A. Top, Yaron Avitzur, Catherine Burton, Pearlie P. Chong, Lara Danziger-Isakov, Anne I. Dipchand, Diane Hébert, Deepali Kumar, Shaun K. Morris, Nadya Nalli, Vicky Lee Ng, Sarah Kogan Nicholas, Joan L. Robinson, Melinda SolomonBruce Tapiero, Anita Verma, Jolan E. Walter, Upton D. Allen

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Growing evidence suggests receipt of live-attenuated viral vaccines after solid organ transplant (SOT) has occurred and is safe and needed due to lapses in herd immunity. A 2-day consortium of experts in infectious diseases, transplantation, vaccinology, and immunology was held with the objective to review evidence and create expert recommendations for clinicians when considering live viral vaccines post-SOT. For consideration of VV and MMR post-transplant, evidence exists only for kidney and liver transplant recipients. For MMR vaccine post-SOT, consider vaccination during outbreak or travel to endemic risk areas. Patients who have received antiproliferative agents (eg. mycophenolate mofetil), T cell–depleting agents, or rituximab; or have persistently elevated EBV viral loads, or are in a state of functional tolerance, should be vaccinated with caution and have a more in-depth evaluation to define benefit of vaccination and net state of immune suppression prior to considering vaccination. MMR and/or VV (not combined MMRV) is considered to be safe in patients who are clinically well, are greater than 1 year after liver or kidney transplant and 2 months after acute rejection episode, can be closely monitored, and meet specific criteria of “low-level” immune suppression as defined in the document.

Original languageEnglish (US)
Article numbere13571
JournalPediatric Transplantation
Volume23
Issue number7
DOIs
StatePublished - Nov 1 2019

Keywords

  • immunization
  • live vaccinations
  • measles-mumps-rubella vaccine
  • solid organ transplant
  • varicella-zoster vaccine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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