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Evaluation of an Accelerated Hepatitis B Vaccination Schedule in Post-Hematopoietic Stem Cell Transplant Pediatric
Rina Yue Ling Ong1, Marcus Wing Choy Loe2, Su-Wan Bianca Chan2,3,4,5
1Division of Pharmacy, KK Women's and Children's Hospital, Singapore, Singapore.
Insights
Pediatric patients receiving hematopoietic stem cell transplants (HSCT) benefit from accelerated revaccination schedules. This approach helps patients mount sufficient immune responses, reducing the risk of infections post-transplant.
Area of Science:
- Immunology
- Pediatrics
- Hematology
Background:
- Revaccination is crucial for pediatric patients after hematopoietic stem cell transplant (HSCT) to prevent infections.
- Current guidelines suggest revaccination timing based on time post-transplant, but optimal timing is not well-defined.
Purpose of the Study:
- To evaluate an accelerated revaccination schedule starting 6 months post-HSCT in pediatric patients.
- To assess the efficacy of this accelerated schedule using hepatitis B seroconversion as a surrogate marker.
Main Methods:
- Implementation of an accelerated revaccination schedule at 6 months post-HSCT.
- Monitoring immune responses, specifically hepatitis B seroconversion, in pediatric patients.
Main Results:
- The accelerated schedule demonstrated that most pediatric patients achieved sufficient immune responses.
- Hepatitis B seroconversion served as a reliable indicator of immune reconstitution.
Conclusions:
- The accelerated revaccination schedule is supported by this study's findings.
- This approach may shorten the period of vulnerability to vaccine-preventable infections in pediatric HSCT recipients.
Abstract:
Revaccination in pediatric post-hematopoietic stem cell transplant (HSCT) patients is important for preventing vaccine-preventable infections. Published guidelines recommend revaccination based on time elapsed post-transplant, though the optimal timing remains unclear. Since May 2019, our institution adopted an accelerated revaccination schedule commencing 6 months post-HSCT and we report our experience. Our study supports the accelerated revaccination schedule, as most pediatric patients were able to mount sufficient immune responses using hepatitis B seroconversion as a surrogate. With the accelerated revaccination schedule, this could also potentially shorten the vulnerable period where patients are at risk of severe vaccine-preventable infections.
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