Response to immunization in children born to renal transplant recipients using immunosuppressive drugs during gestation

Safe administration of rotavirus vaccine in a cohort of infants exposed to immunosuppressive drugs during gestation

“…5 Nevertheless, normal lymphocyte subset numbers are attained in the majority of infants after a few months 5 and they show appropriate humoral immune response to vaccination administered in the first 6 months, with no differences in antibody levels to tetanus, Haemophilus influenzae type b, and 7 pneumococcus serotypes when compared to healthy infants. 6 BCG healing, another live vaccine, was similar to controls in these infants, with no local or systemic adverse events noticed during the 1-year follow-up. 6 The Centers for Disease Control and Prevention (CDC) published in 2009 detailed safety information for solicited adverse events in the 7 days following rotavirus monovalent vaccine: fever (39.8% vs 48.8%), irritability (62.2% vs 61.6%), and diarrhea (6.8% and 5.7%)…”

“…6 BCG healing, another live vaccine, was similar to controls in these infants, with no local or systemic adverse events noticed during the 1-year follow-up. 6 The Centers for Disease Control and Prevention (CDC) published in 2009 detailed safety information for solicited adverse events in the 7 days following rotavirus monovalent vaccine: fever (39.8% vs 48.8%), irritability (62.2% vs 61.6%), and diarrhea (6.8% and 5.7%)…”

“…They have low numbers of B lymphocytes, and also low CD4+ T lymphocytes and NKT cells . Nevertheless, normal lymphocyte subset numbers are attained in the majority of infants after a few months and they show appropriate humoral immune response to vaccination administered in the first 6 months, with no differences in antibody levels to tetanus, Haemophilus influenzae type b, and 7 pneumococcus serotypes when compared to healthy infants . BCG healing, another live vaccine, was similar to controls in these infants, with no local or systemic adverse events noticed during the 1‐year follow‐up …”

“…We are not aware of previous publications on adverse events to rotavirus vaccines in infants exposed in utero to a regimen of 3 immunosuppressive drugs, including azathioprine, prednisone, and 1 calcineurin inhibitor (tacrolimus or cyclosporine). The clear immunological recovery of those infants after some months and their response to immunization to different vaccine antigens administered in the first 6 months of life might explain the absence of adverse events after rotavirus vaccine, suggesting the ability to mount an immune response and to control a live attenuated virus vaccine.…”

“…The transplant group included infants born to kidney transplanted mothers exposed to immunosuppressive drugs during pregnancy, as previously described . Transplanted pregnant women were consecutively recruited from the Hypertension Antenatal Clinic of the Federal University of São Paulo, in São Paulo, Brazil.…”