Language

English

Publication Date

1-1-2025

Journal

American Journal of Transplantation

DOI

10.1016/j.ajt.2024.06.011

PMID

38901562

Abstract

Infections preventable by live virus vaccines are surging in the setting of decreased herd immunity. Many children with chronic liver diseases (CLDs) are unimmunized and at increased risk for infection due to guidelines recommending against live vaccines within 4 weeks pretransplant. This prospective study of 21 children with CLD and 13 healthy controls defined the timing of measles virus and varicella-zoster virus (VZV) RNA- and DNA-emia following vaccination and compared immune responses to measles and varicella vaccines in both groups. Measles virus RNA and VZV DNA real-time PCR were measured weekly following vaccination; measles virus RNA was undetectable in all by 14 days postvaccination, but VZV DNA, which can be managed with antivirals, was detected in 1 child in the CLD group at 21 days and 1 control at 28 days postvaccination. Humoral or cell-mediated vaccine response was 100% to measles virus and 94% to VZV in the CLD group postvaccination, whereas it was 100% to both vaccines in controls. Our pilot study suggests that both live vaccines can be safely and effectively administered up to 14 days prior to transplantation in children with CLD. We anticipate this will improve vaccination rates and thus decrease rates of vaccine-preventable infections in vulnerable children with CLD.

Keywords

Humans, Male, Female, Chickenpox Vaccine, Prospective Studies, Child, DNA, Viral, Vaccines, Attenuated, Herpesvirus 3, Human, Measles Vaccine, Child, Preschool, RNA, Viral, Pilot Projects, Case-Control Studies, Measles, Chronic Disease, Measles virus, Liver Diseases, Follow-Up Studies, Adolescent, Infant, Prognosis, Chickenpox, Antibodies, Viral, Vaccination, live vaccines, measles vaccine, pediatric liver disease, pediatric liver transplantation, vaccine-preventable infections, varicella vaccine

Published Open-Access

yes

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.