Antiviral Immune Response After Live Yellow Fever Vaccination of a Kidney Transplant Recipient Treated With IVIG

Hammarlund, Erika; Lewis, Matthew W.; Poore, Elizabeth A.; Hanifin, Jon M.; Marr, Kieren A.; Hecox, Douglas; Amanna, Ian J.

doi:10.1097/tp.0b013e31828c6d9e

Cited by 16 publications

(9 citation statements)

References 6 publications

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“…In 10 studies the humoral and in two studies cellular and humoral tests were performed. A kidney transplant recipient under CSA and mycophenolic acid vaccinated against YFV 19 years posttransplant reached antibody titers within the lower range of those of controls [57].…”

Section: Sotmentioning

confidence: 87%

Safety of live vaccinations on immunosuppressive therapy in patients with immune-mediated inflammatory diseases, solid organ transplantation or after bone-marrow transplantation – A systematic review of randomized trials, observational studies and case reports

Croce¹,

Hatz

Jonker

et al. 2017

Vaccine

149

121

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Section: Sotmentioning

confidence: 87%

Safety of live vaccinations on immunosuppressive therapy in patients with immune-mediated inflammatory diseases, solid organ transplantation or after bone-marrow transplantation – A systematic review of randomized trials, observational studies and case reports

Croce¹,

Hatz

Jonker

et al. 2017

Vaccine

149

121

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“…4,42 Intravenous immunoglobulin was administered to a renal transplant recipient who was erroneously given yellow fever vaccine, with no evidence of vaccine-associated viscerotropic disease. 50 Further country-specific vaccine information is available from the Centers for Disease Control Yellow Book. 42 Vaccines given prior to transplantation might provide adequate protection.…”

Section: Travel-relatedmentioning

confidence: 99%

Immunization after kidney transplantation—what is necessary and what is safe?

Kotton

2014

Nat Rev Nephrol

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Many transplant recipients are not protected against vaccine-preventable illnesses, primarily because vaccination is still an underutilized tool both before and after transplantation. This missed opportunity for protection can result in substantial morbidity, graft loss and mortality. Immunization strategies should be formulated early in the course of renal disease to maximize the likelihood of vaccine-induced immunity, particularly as booster or secondary antibody responses are less affected by immune compromise than are primary or de novo antibody responses in naive vaccine recipients. However, live vaccines should be avoided in immunocompromised hosts. Although some concern has been raised regarding increased HLA sensitization after vaccination, no clinical data to suggest harm currently exists; overall, non-live vaccines seem to be immunogenic, protective and safe. In organ transplant recipients, some vaccines are indicated based on specific risk factors and certain vaccines, such as hepatitis B, can protect against donor-derived infection. Vaccines given to close contacts of renal transplant recipients can provide an additional layer of protection against infectious diseases. In this article, optimal vaccination of adult transplant recipients, including safety, efficacy, indication and timing, is reviewed.

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“…In cases of severe cellular immunodeficiency, live vaccines are contraindicated due to the risk of fatal viral infections by vaccine strain [18][19][20]. In the review of 675 vaccinations in 317 patients in 15 case series or case reports [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15], viral infections by vaccine strain were observed in 20 cases (3.0%), consisting of 18 patients in 287 varicella vaccines (6.3%) and 2 patients in 121 mumps vaccines (1.7%). The probability of viral infection by vaccine strain might be higher in patients under treatment with immunosuppressive agents than that in healthy children.…”

Section: Discussionmentioning

confidence: 99%

“…However, administration of live vaccine is generally contraindicated in patients receiving immunosuppressive agents. To date, several case series examining immunization using live attenuated vaccines for patients receiving immunosuppressive agents, mainly solid organ transplant recipients, have been published [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. In these reports, live attenuated vaccines were generally effective and safe, and no life-threatening adverse events were observed.…”

Section: Introductionmentioning

confidence: 99%

Prospective study of live attenuated vaccines for patients receiving immunosuppressive agents

et al. 2020

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Patients receiving immunosuppressive agents are at risk of life-threatening infections. However, live vaccines are generally contraindicated in them. We conducted a prospective study regarding live attenuated vaccines for them. Patients elder than one year of age with immunosuppressive agents who showed negative or borderline antibody titers (virus-specific IgG levels < 4.0) against one or more of measles, rubella, varicella, and mumps and fulfilled the criteria (CD4 cell counts � 500/mm 3 , stimulation index of lymphocyte blast transformation by PHA � 101.6, serum IgG level � 300 mg/dl, no steroid use or prednisolone < 1 mg/kg/ day or < 2 mg/kg/2 days, trough levels of tacrolimus or cyclosporine were < 10 ng/ml or < 100 ng/ml and under good control of primary disease) were enrolled. Sixty-four vaccinations were administered to 32 patients. The seroconversion rates for measles, rubella, varicella, and mumps were 80.0%, 100.0%, 59.1%, and 69.2%, respectively. No life-threatening adverse events were observed, although one patient suffered from vaccine-strain varicella who showed cellular and humoral immunodeficiency (CD4 cell counts = 511/mm 3 , stimulation index of lymphocyte blast transformation by PHA = 91.1, serum IgG level = 208 mg/dl). This girl was immunized before we established the criteria for vaccination. Immunization with live attenuated vaccines for patients receiving immunosuppressive agents might be effective and safe if their cellular and humoral immunological parameters are within normal levels. However, determining the criteria for vaccination by immunological parameters should be established to guarantee the safety of live vaccines in the future. Clinical Trial Registration: UMIN Clinical Trials Registry (UMIN-CTR) UMIN000007710. The date of registration: 2012/4/13.

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Antiviral Immune Response After Live Yellow Fever Vaccination of a Kidney Transplant Recipient Treated With IVIG

Cited by 16 publications

References 6 publications

Safety of live vaccinations on immunosuppressive therapy in patients with immune-mediated inflammatory diseases, solid organ transplantation or after bone-marrow transplantation – A systematic review of randomized trials, observational studies and case reports

Safety of live vaccinations on immunosuppressive therapy in patients with immune-mediated inflammatory diseases, solid organ transplantation or after bone-marrow transplantation – A systematic review of randomized trials, observational studies and case reports

Immunization after kidney transplantation—what is necessary and what is safe?

Prospective study of live attenuated vaccines for patients receiving immunosuppressive agents

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