Under-Vaccination in Pediatric Liver Transplant Candidates with Acute and Chronic Liver Disease—A Retrospective Observational Study of the European Reference Network <i>TransplantChild</i>
Tobias Laue,
Zeynep Demir,
Dominique Debray,
Mara Cananzi,
Paola Gaio,
Valeria Casotti,
Lorenzo D’Antiga,
Vaidotas Urbonas,
Ulrich Baumann
Affiliations
Tobias Laue
Department of Paediatric Liver, Kidney and Metabolic Diseases, Division of Paediatric Gastroenterology and Hepatology, Hannover Medical School, 30625 Hannover, Germany
Zeynep Demir
Pediatric Hepatology Unit, Necker Enfants Malades Hospital, 75015 Paris, France
Dominique Debray
Pediatric Hepatology Unit, Necker Enfants Malades Hospital, 75015 Paris, France
Mara Cananzi
Unit of Paediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, University Hospital of Padova, 35142 Padova, Italy
Paola Gaio
Unit of Paediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, University Hospital of Padova, 35142 Padova, Italy
Valeria Casotti
Pediatric Hepatology, Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy
Lorenzo D’Antiga
Pediatric Hepatology, Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy
Vaidotas Urbonas
Clinic of Children’s Diseases, Vilnius University Faculty of Medicine, 08406 Vilnius, Lithuania
Ulrich Baumann
Department of Paediatric Liver, Kidney and Metabolic Diseases, Division of Paediatric Gastroenterology and Hepatology, Hannover Medical School, 30625 Hannover, Germany
Infection is a serious concern in the short and long term after pediatric liver transplantation. Vaccination represents an easy and cheap opportunity to reduce morbidity and mortality due to vaccine-preventable infection. This retrospective, observational, multi-center study examines the immunization status in pediatric liver transplant candidates at the time of transplantation and compares it to a control group of children with acute liver disease. Findings show only 80% were vaccinated age-appropriately, defined as having received the recommended number of vaccination doses for their age prior to transplantation; for DTP-PV-Hib, less than 75% for Hepatitis B and two-thirds for pneumococcal conjugate vaccine in children with chronic liver disease. Vaccination coverage for live vaccines is better compared to the acute control group with 81% versus 62% for measles, mumps and rubella (p = 0.003) and 65% versus 55% for varicella (p = 0.171). Nevertheless, a country-specific comparison with national reference data suggests a lower vaccination coverage in children with chronic liver disease. Our study reveals an under-vaccination in this high-risk group prior to transplantation and underlines the need to improve vaccination.
