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Under-Vaccination in Pediatric Liver Transplant Candidates with Acute and Chronic Liver Disease-A Retrospective Observational Study of the European Reference Network TransplantChild

Affiliation
Department of Paediatric Liver, Kidney and Metabolic Diseases, Division of Paediatric Gastroenterology and Hepatology, Hannover Medical School, 30625 Hannover, Germany
Laue, Tobias;
Affiliation
Pediatric Hepatology Unit, Necker Enfants Malades Hospital, 75015 Paris, France
Demir, Zeynep;
ORCID
0000-0002-0345-963X
Affiliation
Pediatric Hepatology Unit, Necker Enfants Malades Hospital, 75015 Paris, France
Debray, Dominique;
Affiliation
Unit of Paediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, University Hospital of Padova, 35142 Padova, Italy
Cananzi, Mara;
Affiliation
Unit of Paediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, University Hospital of Padova, 35142 Padova, Italy
Gaio, Paola;
Affiliation
Pediatric Hepatology, Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy
Casotti, Valeria;
ORCID
0000-0001-7150-3148
Affiliation
Pediatric Hepatology, Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy
D'Antiga, Lorenzo;
Affiliation
Clinic of Children's Diseases, Vilnius University Faculty of Medicine, 08406 Vilnius, Lithuania
Urbonas, Vaidotas;
GND
1016005113
Affiliation
Department of Paediatric Liver, Kidney and Metabolic Diseases, Division of Paediatric Gastroenterology and Hepatology, Hannover Medical School, 30625 Hannover, Germany
Baumann, Ulrich

Infection is a serious concern in the short and long term after pediatric liver transplantation. Vaccination represents an easy and cheap opportunity to reduce morbidity and mortality due to vaccine-preventable infection. This retrospective, observational, multi-center study examines the immunization status in pediatric liver transplant candidates at the time of transplantation and compares it to a control group of children with acute liver disease. Findings show only 80% were vaccinated age-appropriately, defined as having received the recommended number of vaccination doses for their age prior to transplantation; for DTP-PV-Hib, less than 75% for Hepatitis B and two-thirds for pneumococcal conjugate vaccine in children with chronic liver disease. Vaccination coverage for live vaccines is better compared to the acute control group with 81% versus 62% for measles, mumps and rubella (p = 0.003) and 65% versus 55% for varicella (p = 0.171). Nevertheless, a country-specific comparison with national reference data suggests a lower vaccination coverage in children with chronic liver disease. Our study reveals an under-vaccination in this high-risk group prior to transplantation and underlines the need to improve vaccination.

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