Adherence and immune response to revaccination following hematopoietic stem cell transplantation at a pediatric onco‐hematology reference center

Background Revaccination after hematopoietic stem cell transplantation (HSCT) is necessary to compensate for the loss of immunological memory. The aims of this study were to evaluate the adherence to revaccination schedule and the humoral immune response to different vaccine antigens in HSCT pediatr...

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Published in:Transplant infectious disease 2018-08, Vol.20 (4), p.e12903-n/a
Main Authors: Gouveia‐Alves, Fernanda, Gouveia, Roseane, Ginani, Valéria C., Seber, Adriana, Kuramoto, Danielle A., Murad, Gabriel F.A., Spina, Fernanda G., Petrilli, Antonio S., Zecchin, Victor G., Granato, Celso, Carlesse, Fabianne, Moraes‐Pinto, Maria Isabel
Format: Article
Language:English
Subjects:
Adhesion
Antibodies
antibody
Antigens
Autografts
Chicken pox
Diphtheria
Enzyme-linked immunosorbent assay
Graft-versus-host reaction
Hematology
hematopoietic stem cell transplantation
Hematopoietic stem cells
Hepatitis
Hepatitis A
Hepatitis B
Immune response
Immune response (humoral)
Immune system
Immunological memory
Immunology
Informed consent
Measles
occult hepatitis B virus infection
Patients
Pediatrics
revaccination
Rubella
Stem cell transplantation
Stem cells
Tetanus
Transplantation
Vaccination
Vaccines
Varicella
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Summary:Background Revaccination after hematopoietic stem cell transplantation (HSCT) is necessary to compensate for the loss of immunological memory. The aims of this study were to evaluate the adherence to revaccination schedule and the humoral immune response to different vaccine antigens in HSCT pediatric and young adult patients. Methods Patients submitted to HSCT for over 3 years were recruited. After written informed consent, a questionnaire was filled in, the vaccination card was analyzed, a blood sample was collected and tested by ELISA for diphtheria, Haemophilus influenzae type b (Hib), hepatitis A, hepatitis B, tetanus, measles, rubella, and varicella antibodies. Results Sixty‐three patients (mean age at HSCT, 10.7 years) were evaluated. Forty‐one (65%) were male; 34 (54%) had allogeneic and 29 (46%), autologous HSCT. Complete adherence to diphtheria revaccination was found in 79.4% patients and seropositivity was found in 92% of those who completed the revaccination schedule; for Hib, 68.3% adherence and 95.3% seropositivity were observed; for hepatitis A, 63.5% adherence and 92.5% seropositivity; for 3 doses of hepatitis B, 86.8% adherence and 79.2% seropositivity; for tetanus, 79.4% adherence and 100% seropositivity; for measles and rubella, 17.5% adherence and 100% seropositivity; for varicella, 7.9% adherence and 100% seropositivity. The existence of a Vaccination Center for Special Immunobiologicals in patients' municipality was positively associated with completed vaccine schedule; on the other hand, chronic GVHD was negatively associated with revaccination adherence. Conclusion Hematopoietic stem cell transplantation patients showed good seropositivity rates after complete vaccination schedule. However, a low coverage rate was observed for live attenuated antigens.
ISSN:1398-2273
1399-3062
DOI:10.1111/tid.12903