儿童造血干细胞移植受者再接种模式的回顾性研究。

IF 1 4区 医学 Q3 NURSING
Anne Wohlschlaeger, Ellen Levy, Raabia N Khan, Jennifer Heimall, Brian T Fisher, Talene A Metjian, Caitlin W Elgarten, Jason L Freedman
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引用次数: 2

摘要

背景:造血干细胞移植(HSCT)后,患者几乎没有免疫力来预防感染。重要的是,这包括从以前的接触中获得的免疫力,包括接种疫苗。这种免疫力的丧失是患者先前接受的化疗、放疗和调理方案的直接结果。对HSCT后的患者重新接种疫苗至关重要,以确保对疫苗可预防的疾病具有保护性免疫力。在2017年之前,我们机构的所有患者在HSCT后约12个月被转诊到儿科医生那里重新接种疫苗。我们机构对疫苗接种计划中的不依从性和错误提出了临床关注。方法:为了了解重新接种问题的严重性,我们对2015年至2017年间接受HSCT的患者的疫苗接种后依从性进行了内部审计。成立了一个多学科小组来审查审计结果并提出建议。结果:本次审计显示,疫苗计划的启动出现延误,不完全遵守建议的重新接种计划,以及给药错误。讨论:根据对数据的审查,多学科团队建议在干细胞移植门诊中心内对疫苗准备情况进行系统评估,并集中管理疫苗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Retrospective Review of Revaccination Patterns in Pediatric Hematopoietic Stem Cell Transplantation Recipients.

Background: After a hematopoietic stem cell transplantation (HSCT), patients are left with little to no immunity to prevent infections. Importantly, this includes immunity gained from previous exposures, including vaccinations. This loss of immunity is a direct result of previous chemotherapy, radiation, and conditioning regimens the patients receive. It is critical to revaccinate patients post-HSCT to ensure protective immunity against vaccine-preventable diseases. Before 2017, all patients at our institution were referred to their pediatrician at approximately 12-month post-HSCT to be revaccinated. Clinical concern was raised at our institution regarding nonadherence and errors in vaccine schedules. Methods: To understand the magnitude of the problem with revaccination, we performed an internal audit of post-vaccine adherence in patients who received an HSCT between 2015 and 2017. A multidisciplinary team was developed to review the audit results and make recommendations. Results: This audit revealed delays in the initiation of the vaccine schedule, incomplete adherence to the recommended revaccination schedule, and errors in administration. Discussion: Based on the review of the data, the multidisciplinary team recommended an approach for systematic assessment of vaccine readiness and centralization of the administration of vaccines to be done within the stem cell transplant outpatient center.

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