Jandhyala Deeksha, Lewis Jessica D
Division of Infectious Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Vaccines (Basel). 2020 Oct 22;8(4):622. doi: 10.3390/vaccines8040622.
(1) Background: Vaccination of solid organ transplant (SOT) candidates and recipients is vital to decrease infection-related morbidity and mortality. Here we describe our heart and lung transplant programs' rates of completion of hepatitis B and pneumococcal vaccinations and identify potential opportunities for improvement. (2) Methods: This is a single-center retrospective study that included all heart and lung transplant recipients between 1 July 2013 and 31 July 2018. We assessed demographics, causes of organ failure, pretransplant hepatitis B immune status, and completion rates for hepatitis B vaccine series, pneumococcal conjugate vaccine (PCV13), and pneumococcal polysaccharide vaccine (PPSV23). (3) Results: A total of 41 patients were included in the heart transplant cohort. Twelve (29.3%) had baseline hepatitis B immunity. Only 8/29 (27.6%) completed the entire 3-dose hepatitis B vaccination series pretransplant. Pretransplant PCV13 and PPSV23 vaccination rates were 58.5% (24/41) and 48.8% (20/41), respectively; no additional patients received PCV13 or PPSV23 post-transplant. In the heart transplant cohort, a majority (82.9%) of patients were evaluated by the Transplant Infectious Diseases consultative service (TxID) pretransplant, and this had a statistically significant association with increased pneumococcal vaccination rates ( = 0.0017, PCV13 and = 0.0103, PPSV23). In total, 55 patients were included in the lung transplant cohort. Five (9.1%) had baseline hepatitis B immunity; 33/50 (66.0%) completed the hepatitis B vaccine series in the pretransplant setting. Pretransplant PCV13 and PPSV23 vaccination rate was 40.0% (22/55) and 69.1% (38/55), respectively. There was only a 47.3% and 72.3% completion rate overall in the post-transplant setting. (4) Conclusions: There continues to be a need for a comprehensive and coordinated effort to increase vaccine adherence for all SOT candidates in the pretransplant setting.
（1）背景：对实体器官移植（SOT）候选者和接受者进行疫苗接种对于降低感染相关的发病率和死亡率至关重要。在此，我们描述我们心脏和肺移植项目中乙肝疫苗和肺炎球菌疫苗的接种完成率，并确定潜在的改进机会。（2）方法：这是一项单中心回顾性研究，纳入了2013年7月1日至2018年7月31日期间所有的心脏和肺移植受者。我们评估了人口统计学特征、器官衰竭原因、移植前乙肝免疫状态以及乙肝疫苗系列、肺炎球菌结合疫苗（PCV13）和肺炎球菌多糖疫苗（PPSV23）的接种完成率。（3）结果：心脏移植队列共纳入41例患者。12例（29.3%）有基线乙肝免疫力。移植前仅8/29例（27.6%）完成了完整的3剂乙肝疫苗接种系列。移植前PCV13和PPSV23的接种率分别为58.5%（24/41）和48.8%（20/41）；移植后没有额外的患者接种PCV13或PPSV23。在心脏移植队列中，大多数（82.9%）患者在移植前接受了移植传染病咨询服务（TxID）的评估，这与肺炎球菌疫苗接种率增加有统计学显著关联（PCV13，P = 0.0017；PPSV23，P = 0.0103）。肺移植队列共纳入55例患者。5例（9.1%）有基线乙肝免疫力；50例中的33例（66.0%）在移植前完成了乙肝疫苗系列接种。移植前PCV13和PPSV23的接种率分别为40.0%（22/55）和69.1%（38/55）。移植后总体完成率分别仅为47.3%和72.3%。（4）结论：仍需要进行全面协调的努力，以提高所有移植前SOT候选者的疫苗接种依从性。
