1645. Adherence to Vaccination Guidelines in Patients Awaiting Kidney or Kidney-Pancreas Transplant
Session: Poster Abstract Session: Vaccine Strategy and Policy
Friday, October 6, 2017
Room: Poster Hall CD
Posters
  • Pallotta IDSA Poster 090617.pdf (13.4 kB)
  • Background: Vaccines are a component of preventative medicine; however, low vaccination rates in the organ transplant population are concerning due to increased risk of morbidity caused by common, preventable infections. Pre-transplant vaccination rates were evaluated among adult kidney transplant recipients; patient demographics and vaccination rates were described in patients evaluated by Infectious Disease prior to transplant.

    Methods: A retrospective chart review included adult transplant recipients receiving kidney or kidney-pancreas transplants from October 2013 to October 2016. Pre-transplant vaccination history, laboratory markers of immunity, baseline demographics, and transplant data were collected utilizing the electronic medical record and Ohio Department of Health immunization database.

    Results: A total of 393 transplant recipients were evaluated (55% deceased donor). The median patient age was 53 years old.  The most common indications for transplant were diabetes mellitus and sclerotic diseases with 81% of patients on dialysis prior to transplant. The vaccination rate for influenza and pneumococcal vaccines are reported below.

    Vaccination Rates (%)

     

    Overall

    ID Evaluation

    No ID

    Evaluation

    P value

    Dialysis

    No Dialysis

    P value

    Influenza

    48

    67

    46

    0.04

    49

    43

    0.39

    One pneumococcal

    77

    92

    76

    0.05

    83

    55

    <0.01

    Both pneumococcal

    6

    33

    4

    <0.01

    7

    5

    0.80

    Patients on dialysis tended to have higher vaccination rates as compared to those who received a preemptive transplant, specifically for at least one pneumococcal vaccine, hepatitis B, and varicella.  Twenty-seven (7%) of patients had pre-transplant evaluations by Infectious Disease; most commonly in the setting of foreign travel/birth or HIV positivity.  Patients evaluated by Infectious Disease pre-transplant had higher vaccination rates, particularly for influenza, pneumococcal, hepatitis B, zoster, MMR and Tdap vaccines.

    Conclusion: Vaccination rates were higher among transplant candidates receiving dialysis and evaluated by Infectious Disease prior to transplant, but remain suboptimal. Dedicated members of the medical team should focus attention on this issue in the pre-transplant process in order to increase vaccination rates in this at-risk population.

    Ashley Kasper, PharmD1, Michael Spinner, MA, PharmD1, Christopher Kovacs, MD2 and Andrea Pallotta, PharmD1, (1)Pharmacy, Cleveland Clinic, Cleveland, OH, (2)Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH

    Disclosures:

    A. Kasper, None

    M. Spinner, None

    C. Kovacs, None

    A. Pallotta, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.