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

Author:

Donà Daniele1ORCID,Bravo‐Gallego Luz Yadira2ORCID,Remacha Esteban Frauca3,Cananzi Mara4,Gastaldi Andrea15,Canizalez Juan Torres2,Stephenne Xavier6,Lacaille Florence7,Lindemans Caroline8,Calore Elisabetta9,Galea Nathalie10,Benetti Elisa11,Nachbaur Edith12,Sandes Ana Rita13,Teixeira Ana14,Ferreira Sandra15,Klaudel‐Dreszler Maja16,Ackermann Oanez17,Boyer Olivia1819ORCID,Espinosa Laura20,Guereta Luis García21,Sciveres Marco22,Fischler Björn2324,Schwerk Nicolaus25,Neland Mette26,Nicastro Emanuele27,Dello Strologo Luca28ORCID,Toporski Jacek2930ORCID,Vainumae Inga31,Rascon Jelena32ORCID,Urbonas Vaidotas33,del Rosal Teresa34,López‐Granados Eduardo235,Perilongo Giorgio36,Baker Alastair37,Vega Paloma Jara38,

Affiliation:

1. Division of Pediatric Infectious Diseases, Department of Women's and Children's Health University Hospital of Padua Padua Italy

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

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

4. 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

5. Department of Pediatrics, Woman and Child Hospital University of Verona Verona Italy

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

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

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

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

10. Paediatric Department of Mater Dei Hospital Msida Malta

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

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

13. 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

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

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

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

17. 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

18. 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

19. Institut Imagine, Laboratoire des maladies rénales héréditaires, INSERM UMR 1163, Université de Paris Paris France

20. 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

21. Pediatric Cardiology Department La Paz University Hospital Madrid Spain

22. Pediatric Hepatology and Liver Transplantation ISMETT‐University of Pittsburgh Medical Center Italy Palermo Italy

23. Department of Pediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden

24. Department of Clinical Science, Intervention and Technology, CLINTEC Karolinska Institutet Stockholm Sweden

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

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

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

28. Nephrology Unit Bambino Gesù Children's Research Hospital, IRCCS Rome Italy

29. Department of Pediatrics, Section of Pediatric Oncology, Hematology, Immunology and Nephrology Skåne University Hospital Lund Sweden

30. Center of Allogenic Stem Cell Transplantation and Cellular Therapy Karolinska University Hospital Stockholm Sweden

31. Department of Pediatrics Tartu University Hospital Tartu Estonia

32. Centre for Paediatric Oncology and Haematology Vilnius University Hospital Santaros Klinikos Vilnius Lithuania

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

34. 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

35. Clinical Immunology Department La Paz University Hospital Madrid Spain

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

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

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

Abstract

AbstractBackgroundThere 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.MethodsA 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.ResultsA 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.ConclusionsThe 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.

Funder

European Commission

Publisher

Wiley

Subject

Transplantation,Pediatrics, Perinatology and Child Health

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