Recommendations for immunizations in stem cell transplantation.
Investigations over the past decade have documented that there is a decline in immunity to vaccine preventable diseases in many SCT recipients. The majority of immunization studies conducted in SCT recipients to date support the use of multi-dose regimens for most protein and polysaccharide-conjugate vaccine antigens. The consensus immunization schedule recommended by ACIP/IDSA/ASBMT provides guidance for centers to utilize available vaccines in their SCT populations. With the exception of pneumococcal disease, a schedule beginning at 12 months after SCT is reasonable given the low incidence of disease in HSCT recipients for most of the recommended vaccines and improved immune reconstitution in most recipients by one year post transplant. SCT recipients respond poorly to unconjugated pneumococcal polysaccharide vaccine and the development of polysaccharide-protein conjugate vaccines against S. pneumoniae holds promise to impact potentially on clinical disease in this population. In addition, the strategy of donor immunization may also be effective in eliciting early protective immune responses to vaccine antigens. Future challenges will be the development of safe and effective vaccines against the viral pathogens responsible for considerable morbidity and mortality after SCT.
Molrine
Deborah C
DC
University of Massachusetts Biologic Laboratories, 305 South Street, Jamaica Plain, MA 02130-3597, USA.
D019433:Chickenpox Vaccine / Q000008:administration & dosage; D002648:Child; D036101:Cord Blood Stem Cell Transplantation; D018380:Hematopoietic Stem Cell Transplantation; D022362:Hepatitis A Vaccines / Q000008:administration & dosage; D006801:Humans; D007114:Immunization; D007115:Immunization Schedule; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011184:Postoperative Period; D033581:Stem Cell Transplantation; D014181:Transplantation Immunology
D019433:Chickenpox Vaccine; D022362:Hepatitis A Vaccines; D022242:Pneumococcal Vaccines