TY - JOUR
T1 - Live vaccines after pediatric solid organ transplant
T2 - Proceedings of a consensus meeting, 2018
AU - Suresh, Sneha
AU - Upton, Julia
AU - Green, Michael
AU - Pham-Huy, Anne
AU - Posfay-Barbe, Klara M.
AU - Michaels, Marian G.
AU - Top, Karina A.
AU - Avitzur, Yaron
AU - Burton, Catherine
AU - Chong, Pearlie P.
AU - Danziger-Isakov, Lara
AU - Dipchand, Anne I.
AU - Hébert, Diane
AU - Kumar, Deepali
AU - Morris, Shaun K.
AU - Nalli, Nadya
AU - Ng, Vicky Lee
AU - Nicholas, Sarah Kogan
AU - Robinson, Joan L.
AU - Solomon, Melinda
AU - Tapiero, Bruce
AU - Verma, Anita
AU - Walter, Jolan E.
AU - Allen, Upton D.
N1 - Publisher Copyright:
© 2019 Wiley Periodicals, Inc.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - 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.
AB - 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.
KW - immunization
KW - live vaccinations
KW - measles-mumps-rubella vaccine
KW - solid organ transplant
KW - varicella-zoster vaccine
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U2 - 10.1111/petr.13571
DO - 10.1111/petr.13571
M3 - Article
C2 - 31497926
AN - SCOPUS:85071930524
SN - 1397-3142
VL - 23
JO - Pediatric Transplantation
JF - Pediatric Transplantation
IS - 7
M1 - e13571
ER -