Long-Term Varicella Zoster Virus Immunity in Paediatric Liver Transplant Patients Can Be Achieved by Booster Vaccinations—A Single-Centre, Retrospective, Observational Analysis
Bibliographic Data
| ID | 15714241 |
|---|---|
| Authors | Tobias Laue (0009-0003-3784-1444, Medizinische Hochschule Hannover, corresponding author), Elisabeth Oms (Medizinische Hochschule Hannover), Johanna Ohlendorf (0000-0002-7994-7656, Medizinische Hochschule Hannover), Ulrich Baumann (0000-0002-0162-0266, Medizinische Hochschule Hannover) |
| Year | 2022 |
| Volume | 9 |
| Issue | 2 |
| Pages | 130-130 |
| Publication date | 2022-01-19 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Children (JOURNAL) |
| Journal identifiers | ISSN: 2227-9067 • E-ISSN: 2227-9067 |
| Publisher | Multidisciplinary Digital Publishing Institute (PUBLISHER • CH) |
| DOI | 10.3390/children9020130 |
| PMID | 35204851 |
| OpenAlex | W4206197100 |
| Language | EN |
| References cited | 38 |
Varicella is one of the most common vaccine-preventable infections after paediatric solid organ transplantation; thus, vaccination offers simple and cheap protection. However, children with liver disease often progress to liver transplantation (LT) before they reach the recommended vaccination age. As a live vaccine, varicella zoster virus (VZV) vaccination after transplantation is controversial; however, many case series demonstrate that vaccination may be safe and effective in paediatric liver transplant recipients. Only limited data exists describing long-term vaccination response in such immunocompromised patients. We investigated retrospectively vaccination response in paediatric patients before and after transplantation and describe long-term immunity over ten years, including the influence of booster-vaccinations. In this retrospective, single-centre study, 458 LT recipients were analysed between September 2004 and June 2021. Of these, 53 were re-transplantations. Patients with no available vaccination records and with a history of post-transplant lymphoproliferative disease, after hematopoietic stem cell transplantation and clinical chickenpox were excluded from this analysis ( n = 198). In total, data on 207 children with a median annual follow-up of 6.2 years was available: 95 patients (45.9%) were unvaccinated prior to LT. Compared to healthy children, the response to vaccination, measured by seroconversion, is weaker in children with liver disease: almost 70% after one vaccination and 93% after two vaccinations. One year after transplantation, the mean titres and the number of children with protective antibody levels (VZV IgG ≥ 50 IU/L) decreased from 77.5% to 41.3%. Neither diagnosis, gender, nor age were predictors of vaccination response. Booster-vaccination was recommended for children after seroreversion using annual titre measurements and led to a significant increase in mean titre and number of protected children. Response to vaccination shows no difference from monotherapy with a calcineurin inhibitor to intensified immunosuppression by adding prednisolone or mycophenolate mofetil. Children with liver disease show weaker seroconversion rates to VZV vaccination compared to healthy children. Therefore, VZV-naïve children should receive basic immunization with two vaccine doses as well as those vaccinated only once before transplantation. An average of 2-3 vaccine doses are required in order to achieve a long-term seroconversion and protective antibody levels in 95% of children
Booster (rocketry · Booster dose · Chickenpox · Immune system · Immunization · Liver transplantation · Seroconversion · Vaccination · Varicella zoster virus · Virus · Animal Virus Infections Studies · Hepatitis B Virus Studies · Herpesvirus Infections and Treatments · Medicine · Immunology · Pediatrics · Surgery · Transplantation
| Highly cited | No |
|---|