Related Experiment Video
Updated: Feb 21, 2026
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Incomplete vaccination coverage in European children with end-stage kidney disease prior to renal transplantation
Britta Höcker1, Martin Aguilar1, Paul Schnitzler2
1Department of Paediatrics I, University Children's Hospital, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany.
Insights
Vaccination coverage in children awaiting kidney transplants is critically low, increasing their risk of infections. Improving pre-transplant vaccination rates is essential for better patient outcomes and reduced morbidity.
Area of Science:
- Pediatric Nephrology
- Transplantation Immunology
- Vaccinology
Background:
- Infections are a major cause of morbidity and mortality in pediatric renal allograft recipients.
- Pre-transplant vaccination is crucial for preventing systemic infections but data on coverage is scarce.
Purpose of the Study:
- To investigate vaccination coverage in pediatric kidney transplant candidates.
- To identify factors associated with incomplete vaccination coverage.
Main Methods:
- A multi-center, multi-national retrospective study.
- Investigated 254 European children with end-stage renal disease before transplantation.
Main Results:
- Only 8.7% of patients had complete vaccination coverage.
- Low coverage for human papillomavirus (27.3%), pneumococci (42.0%), and meningococci (47.9%).
- Incomplete vaccination was linked to non-Caucasian ethnicity, chronic dialysis, and older age at transplantation.
Conclusions:
- Vaccination coverage in pediatric kidney transplant candidates is incomplete.
- Pediatric nephrologists, primary care staff, and families must improve pre-transplant vaccination rates.
Background:
Because infections constitute a major cause of morbidity and mortality in paediatric renal allograft recipients, avoidance of preventable systemic infections by vaccination before transplantation is of utmost importance. However, data on the completeness of vaccinations and factors associated with incomplete vaccination coverage are scarce.
Methods:
Within the framework of the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN), we therefore performed a multi-centre, multi-national, retrospective study investigating the vaccination coverage before transplantation of 254 European children with end-stage renal disease (mean age 10.0 ± 5.6 years).
Results:
Only 22 out of 254 patients (8.7%) presented complete vaccination coverage. In particular, the respective vaccination coverage against human papillomavirus (27.3%), pneumococci (42.0%), and meningococci (47.9%) was low. Patients with complete pneumococcal vaccination coverage had numerically less lower respiratory tract infections during the first 3 years post-transplant than children without vaccination or with an incomplete status (16.4% vs 27.7%, p = 0.081). Vaccine-preventable diseases post-transplant were 4.0 times more frequently in unvaccinated than in vaccinated patients. Factors associated with an incomplete vaccination coverage were non-Caucasian ethnicity (OR 9.21, p = 0.004), chronic dialysis treatment before transplantation (OR 6.18, p = 0.001), and older age at transplantation (OR 1.33, p < 0.001).
Conclusions:
The vaccination coverage in paediatric kidney transplant candidates is incomplete. Paediatric nephrologists, together with primary-care staff and patients' families, should therefore make every effort to improve vaccination rates before kidney transplantation.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:16Kidney Transplant III: Nursing Management
01:26Kidney Transplant II: Surgical Procedure
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:25Chronic Kidney Disease I: Introduction