Approaches to pretransplant vaccination

Area of Science:

• Transplantation immunology
• Vaccinology
• Public health

Background:

• Pretransplant vaccination is more effective than posttransplant vaccination for improving immune response.
• COVID-19 vaccination and associated requirements are a key focus in pretransplant care.
• Vaccine hesitancy among transplant candidates poses a significant challenge.

Approach:

• Summarizing current data and perspectives on pretransplant vaccination strategies.
• Identifying and characterizing barriers to pretransplant vaccination, including hesitancy.
• Analyzing ethical principles guiding COVID-19 vaccination requirements in transplant centers.

Key Points:

• Pretransplant vaccination yields superior immunity markers and clinical benefits.
• Barriers to vaccination are categorized as hard stops (availability, safety), soft stops (convenience, coordination), and volitional stops (hesitancy).
• Addressing vaccine hesitancy requires understanding patient concerns about side effects and safety.

Conclusions:

• Optimizing pretransplant vaccination requires overcoming logistical and hesitancy-related barriers.
• Implementation of vaccination requirements is informed by ethical considerations.
• Further research and targeted interventions are needed to enhance pretransplant immunization coverage.