دورية أكاديمية
Safety and Immunogenicity of Live Viral Vaccines in a Multicenter Cohort of Pediatric Transplant Recipients.
| العنوان: | Safety and Immunogenicity of Live Viral Vaccines in a Multicenter Cohort of Pediatric Transplant Recipients. |
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| المؤلفون: | Feldman AG; Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, University of Colorado and Children's Hospital Colorado, Aurora.; Adult & Child Center for Outcomes Research & Delivery Science (ACCORDS), University of Colorado and Children's Hospital Colorado, Aurora., Beaty BL; Adult & Child Center for Outcomes Research & Delivery Science (ACCORDS), University of Colorado and Children's Hospital Colorado, Aurora., Ferrolino JA; Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, Tennessee., Maron G; Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, Tennessee., Weidner HK; Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio., Ali SA; Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia., Bitterfeld L; Intermountain Primary Children's Hospital, Salt Lake City, Utah., Boulware MA; Levine Children's Hospital at Atrium Health, Charlotte, North Carolina., Campbell KM; Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio., Carr E; Yale University, New Haven, Connecticut., Chapman S; Children's Wisconsin, Medical College of Wisconsin, Milwaukee., Chang YC; Duke University Medical Center, Durham, North Carolina., Cunningham R; NYU Grossman School of Medicine, New York, New York., Dallas RH; Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, Tennessee., Dantuluri KL; Levine Children's Hospital at Atrium Health, Charlotte, North Carolina., Domenick BN; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Ebel NH; Lucile Packard Children's Hospital at Stanford, Palo Alto, California., Elisofon S; Boston Children's Hospital, Boston, Massachusetts., Fawaz R; Yale University, New Haven, Connecticut., Foca M; Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York., Gans HA; Lucile Packard Children's Hospital at Stanford, Palo Alto, California., Gopalareddy VV; Levine Children's Hospital at Atrium Health, Charlotte, North Carolina., Gu C; Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, New York., Gupta NA; Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia., Harmann K; Lucile Packard Children's Hospital at Stanford, Palo Alto, California., Hollenbeck J; C.S. Mott Children's Hospital, Michigan Medicine, Ann Arbor., Huppler AR; Children's Wisconsin, Medical College of Wisconsin, Milwaukee., Jaramillo C; Intermountain Primary Children's Hospital, Salt Lake City, Utah., Kasi N; Medical University of South Carolina Shawn Jenkins Children's Hospital, Charleston., Kerkar N; Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, New York., Lerret S; Children's Wisconsin, Medical College of Wisconsin, Milwaukee., Lobritto SJ; Children's Hospital of New York, NewYork-Presbyterian Hospital, New York., Lopez MJ; C.S. Mott Children's Hospital, Michigan Medicine, Ann Arbor., Marini E; Boston Children's Hospital, Boston, Massachusetts., Mavis A; Levine Children's Hospital at Atrium Health, Charlotte, North Carolina., Mehra S; Intermountain Primary Children's Hospital, Salt Lake City, Utah., Moats L; Duke University Medical Center, Durham, North Carolina., Mohandas S; Children's Hospital Los Angeles, Los Angeles, California., Munoz FM; Texan Children's Hospital, Baylor College of Medicine, Houston, Texas., Mysore KR; Texan Children's Hospital, Baylor College of Medicine, Houston, Texas., Onsan C; C.S. Mott Children's Hospital, Michigan Medicine, Ann Arbor., Ovchinsky N; NYU Grossman School of Medicine, New York, New York., Perkins K; Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio., Postma S; Washington University School of Medicine, St Louis, Missouri., Pratscher L; Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, University of Colorado and Children's Hospital Colorado, Aurora., Rand EB; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Rowe RK; Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, New York., Schultz D; C.S. Mott Children's Hospital, Michigan Medicine, Ann Arbor., Sear K; Lucile Packard Children's Hospital at Stanford, Palo Alto, California., Sell ML; Medical University of South Carolina Shawn Jenkins Children's Hospital, Charleston., Sharma T; Boston Children's Hospital, Boston, Massachusetts., Stoll J; Washington University School of Medicine, St Louis, Missouri., Vang M; Children's Wisconsin, Medical College of Wisconsin, Milwaukee., Villarin D; Texan Children's Hospital, Baylor College of Medicine, Houston, Texas., Weaver C; Children's Hospital Los Angeles, Los Angeles, California., Wood P; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Woodford-Berry O; Children's Hospital of New York, NewYork-Presbyterian Hospital, New York., Yanni G; Children's Hospital Los Angeles, Los Angeles, California., Danziger-Isakov LA; Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio. |
| المصدر: | JAMA network open [JAMA Netw Open] 2023 Oct 02; Vol. 6 (10), pp. e2337602. Date of Electronic Publication: 2023 Oct 02. |
| نوع المنشور: | Multicenter Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Chicago, IL : American Medical Association, [2018]- |
| مواضيع طبية MeSH: | Viral Vaccines* , Chickenpox*/prevention & control , Mumps* , Rubella*/prevention & control , Measles*/prevention & control, Child ; Humans ; Child, Preschool ; Adolescent ; Chickenpox Vaccine/adverse effects ; Vaccines, Combined ; Transplant Recipients ; Cohort Studies ; Vaccines, Attenuated/adverse effects |
| مستخلص: | Importance: Live vaccines (measles-mumps-rubella [MMR] and varicella-zoster virus [VZV]) have not been recommended after solid organ transplant due to concern for inciting vaccine strain infection in an immunocompromised host. However, the rates of measles, mumps, and varicella are rising nationally and internationally, leaving susceptible immunocompromised children at risk for life-threating conditions. Objective: To determine the safety and immunogenicity of live vaccines in pediatric liver and kidney transplant recipients. Design, Setting, and Participants: This cohort study included select pediatric liver and kidney transplant recipients who had not completed their primary MMR and VZV vaccine series and/or who displayed nonprotective serum antibody levels at enrollment between January 1, 2002, and February 28, 2023. Eligibility for live vaccine was determined by individual US pediatric solid organ transplant center protocols. Exposures: Exposure was defined as receipt of a posttransplant live vaccine. Transplant recipients received 1 to 3 doses of MMR vaccine and/or 1 to 3 doses of VZV vaccine. Main Outcome and Measure: Safety data were collected following each vaccination, and antibody levels were obtained at 0 to 3 months and 1 year following vaccination. Comparisons were performed using Mann-Whitney U test, and factors associated with development of postvaccination protective antibodies were explored using univariate analysis. Results: The cohort included 281 children (270 [96%] liver, 9 [3%] kidney, 2 [1%] liver-kidney recipients) from 18 centers. The median time from transplant to enrollment was 6.3 years (IQR, 3.4-11.1 years). The median age at first posttransplant vaccine was 8.9 years (IQR, 4.7-13.8 years). A total of 202 of 275 (73%) children were receiving low-level monotherapy immunosuppression at the time of vaccination. The majority of children developed protective antibodies following vaccination (107 of 149 [72%] varicella, 130 of 152 [86%] measles, 100 of 120 [83%] mumps, and 124 of 125 [99%] rubella). One year post vaccination, the majority of children who initially mounted protective antibodies maintained this protection (34 of 44 [77%] varicella, 45 of 49 [92%] measles, 35 of 42 [83%] mumps, 51 of 54 [94%] rubella). Five children developed clinical varicella, all of which resolved within 1 week. There were no cases of measles or rubella and no episodes of graft rejection within 1 month of vaccination. There was no association between antibody response and immunosuppression level at the time of vaccination. Conclusions and Relevance: The findings suggest that live vaccinations may be safe and immunogenic after solid organ transplant in select pediatric recipients and can offer protection against circulating measles, mumps, and varicella. |
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| معلومات مُعتمدة: | UL1 TR001863 United States TR NCATS NIH HHS |
| المشرفين على المادة: | 0 (Viral Vaccines) 0 (Chickenpox Vaccine) 0 (Vaccines, Combined) 0 (Vaccines, Attenuated) |
| تواريخ الأحداث: | Date Created: 20231012 Date Completed: 20231023 Latest Revision: 20240312 |
| رمز التحديث: | 20240312 |
| مُعرف محوري في PubMed: | PMC10570873 |
| DOI: | 10.1001/jamanetworkopen.2023.37602 |
| PMID: | 37824141 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2574-3805 |
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| DOI: | 10.1001/jamanetworkopen.2023.37602 |