Importance of optimizing routine immunization schedules in pediatric heart transplantation

Objective

Vaccination is the most effective preventive measure to reduce the risk of infection in patients receiving immunosuppressive treatment, such as heart transplant (HT) patients. The objectives of this study are to describe and evaluate the vaccination status of a group of pediatric HT recipients.

Material and methods

Retrospective descriptive study of 75 pediatric patients who underwent HT at a tertiary hospital between January 2000 and September 2020. Demographic, clinical (immunization before and after HT, and attendance to vaccination counselling consultation), and analytical (hepatitis A and B serology before and after HT) variables were collected.

Results

Patients > 12 months reached the HT with better vaccination coverage than those < 12 months: 78.9 % versus 60.7 % had a complete vaccination schedule (P = .15). Post-HT vaccination update rate is low; only 13.3 % of patients had a complete schedule according to their age. The post-HT vaccination update of the human papillomavirus vaccine is higher in women (P = .02). We did not find statistical differences between other vaccines according to sex. A total of 13.3 % of patients attended post-HT vaccination counselling consultation, being better immunised than those who did not (P = .01).

Conclusions

The evaluation and optimization of vaccination schedules of patients with HT remains suboptimal. A follow-up of these patients and their relatives in vaccination specialised consultations can improve the immunization status of pediatric HT recipients.