Incidence and Risk of Common Vaccine Preventable Diseases among Transplant Recipients in Korea: A Nationwide...

Infection remains a leading cause of mortality among transplant recipients. Studies on vaccine-preventable diseases (VPDs) among transplant recipients in Asia are lacking. This study aimed to investigate the incidence and risk of VPD in transplant recipients in Korea.

Individuals who underwent transplantation were retrospectively recruited using data from the Korea National Health Insurance system from 2008 to 2020. We selected four major VPDs-varicella, invasive pneumococcal disease (IPD), mumps, and pertussis-and evaluated the cumulative incidence rate and standardized incidence ratio (SIR), comparing it to that of the general population.

A total of 55,363 transplant recipients were included. Among these, 1,503 cases of the four VPDs were identified. Multivariable analysis revealed a significantly higher risk of varicella in children and allogeneic hematopoietic stem cell transplantation recipients. Conversely, for IPD, the risk was higher among individuals aged ≥60 years and in solid organ transplantation recipients; however, the difference was not significant. The SIR for varicella was notably higher in adult recipients aged ≥ 20 years (SIR, 2.79; 95% confidence interval [CI], 2.53-3.06; SIR, 6.02; 95% CI, 4.89-7.33), while for IPD, the SIR for all ages was notably increased at 20.3 (95% CI, 18.72-21.96). For mumps, the SIR was significantly lower at 0.24 (95% CI, 0.19-0.30) across all age groups. Conversely, for pertussis, the SIR was 0.67 (95% CI, 0.32-1.24), but the difference was not significant.

These findings underscore that transplant recipients are still at higher risk of getting VPDs than is the general population, emphasizing the importance of surveillance and vaccination efforts.