Vaccination in Kidney Transplant Candidates

Area of Science:

• Nephrology
• Transplant Immunology
• Vaccinology

Background:

• Kidney transplant (KT) candidates often present with historically low immunization rates for recommended vaccines.
• Assessing vaccination status and uptake in this vulnerable population is crucial for preventing infections post-transplant.

Purpose of the Study:

• To evaluate the baseline vaccination rates and seropositivity for essential vaccines in kidney transplant candidates.
• To determine vaccine uptake among eligible candidates during the pre-transplant evaluation period.

Main Methods:

• Retrospective study of 150 KT candidates (≥18 years) evaluated between January 2020 and December 2020.
• Assessed prior vaccination history for tetanus, diphtheria, pertussis, pneumococcal (PCV13, PPSV23), and recombinant zoster vaccines.
• Measured seropositivity for Hepatitis A, Hepatitis B, measles, mumps, rubella, and varicella using IgG antibodies as immune markers.

Main Results:

• Low baseline vaccination rates were observed, with only 11% having received tetanus, diphtheria, pertussis, PCV13, PPSV23, or zoster vaccines.
• Seropositivity rates varied: Hepatitis A (30%), Hepatitis B (66%), measles (88%), mumps (78%), rubella (90%), and varicella (96%).
• Only 5% of candidates had complete immunization or seropositivity; Hepatitis A vaccine declination was notable (16% of eligible).

Conclusions:

• Kidney transplant candidates exhibit low baseline immunization and seropositivity for several critical vaccines.
• Despite low baseline rates, overall vaccine uptake among eligible candidates was high, suggesting successful pre-transplant immunization strategies.