Adherence and immune response to revaccination following hematopoietic stem cell transplantation at a pediatric onco-hematology reference center.
Transpl Infect Dis. 2018 Apr 18;:e12903
Authors: Gouveia-Alves F, Gouveia R, Ginani VC, Seber A, Kuramoto DA, Murad GFA, Spina FG, Petrilli AS, Zecchin VG, Granato C, Carlesse F, de Moraes-Pinto MI
BACKGROUND: Revaccination after hematopoietic stem cell transplantation (HSCT) is necessary to compensate for the loss of immunological memory. The aims of this study were to evaluate the adherence to revaccination schedule and the humoral immune response to different vaccine antigens in HSCT pediatric and young adult patients.
METHODS: Patients submitted to HSCT for over 3 years were recruited. After written informed consent, a questionnaire was filled in, the vaccination card was analyzed, a blood sample was collected and tested by ELISA for diphtheria, Haemophilus influenzae type b (Hib), hepatitis A, hepatitis B, tetanus, measles
, rubella and varicella antibodies.
RESULTS: Sixty-three patients (mean age at HSCT, 10.7y) were evaluated. Forty-one (65%) were male; 34 (54%) had allogeneic and 29 (46%), autologous HSCT. Complete adherence to diphtheria revaccination was found in 79.4% patients and seropositivity was found in 92% of those who completed the revaccination schedule; for Hib, 68.3% adherence and 95.3% seropositivity were observed; for hepatitis A, 63.5% adherence and 92.5% seropositivity; for 3 doses of hepatitis B, 86.8% adherence and 79.2% seropositivity; for tetanus, 79.4% adherence and 100% seropositivity; for measles
and rubella, 17.5% adherence and 100% seropositivity; for varicella, 7.9% adherence and 100% seropositivity. The existence of a Vaccination Center for Special Immunobiologicals in patients' municipality was positively associated with completed vaccine schedule; on the other hand, chronic GVHD was negatively associated with revaccination adherence.
CONCLUSION: HSCT patients showed good seropositivity rates after complete vaccination schedule. However, a low coverage rate was observed for live attenuated antigens. This article is protected by copyright. All rights reserved.
PMID: 29668078 [PubMed - as supplied by publisher]