Improving Vaccination Rates in Adult Solid Organ Transplant Candidates: Impact of an Infectious Diseases Pretransplant Clinic.

Abstract

Background: Despite guidelines recommending pretransplant immunizations for solid organ transplant candidates (SOTc), vaccine uptake is suboptimal. We evaluated the impact of an Infectious Disease Pretransplant (IDPT) clinic for improving vaccinations in SOTc.

Methods: A retrospective quality improvement study of SOTc seen in the IDPT clinic between January 2020 and February 2021 at the Henry Ford Transplant Institute. Vaccination status before (pre-IDPT clinic visit) and 6 months after (post-IDPT clinic visit) were determined for influenza, pneumococcus, hepatitis B, hepatitis A, tetanus, and zoster vaccines. Differences in per-person year (PPY) vaccination rates and uptake of each vaccine type between the two time points were assessed. Factors associated with vaccine completion (at least one dose of six adult vaccines) in the post-IDPT clinic visit period were analyzed with logistic regression.

Results: Of the 200 SOTc included, 60% were men. Vaccination rates were significantly higher in the post-IDPT clinic visit period; difference in median PPY vaccination rate was 0.61 (p < 0.001). Uptake was statistically significant for all six vaccine classes. A total of 29% patients completed vaccination. Increasing age was associated with likelihood of vaccine completion (odds ratio [OR], 1.14; 95% CI 1.08-1.21). Heart and lung transplant candidates had significantly higher odds of vaccine completion than kidney candidates after IDPT clinic visits (Heart: OR, 7.01; 95% CI 2.39-20.55) (Lung: OR, 10.76; 95% CI 3.56-32.55).

Conclusion: IDPT clinic visits significantly increased vaccination rates in SOTc, especially in heart and lung transplant candidates. The IDPT clinic optimized vaccine completion for this highly vulnerable population.