title: Influenza vaccine after pediatric kidney transplant: a Midwest Pediatric Nephrology Consortium study.
abstract: The main aim of this study was to compare the response to trivalent inactivated influenza vaccine in children who received a kidney transplant and were on steroid-free versus steroid-based immunosuppression. Groups: 1. Kidney transplant recipients on steroid-free immunosuppression (n=27); 2. Kidney transplant recipients on steroid-based immunosuppression (n=39); 3. Healthy controls (n=21). Hemagglutination inhibition titers against 2007-2008 A/H1N1 and A/H3N2 and B strains were measured before and 8 weeks postvaccination. Postvaccination geometric mean titers to A/H1N1 were significantly lower among both transplant groups than controls (p=0.025 and 0.015, respectively). Postvaccination titers to H3N2 and B strains were not statistically different between groups. Proportions of participants developing seroprotection were not different among groups. Both kidney transplant groups seroconverted less than controls for A/H1N1 (p=0.0002) and were no different from controls for B. For A/H3N2, the steroid-free group had the weakest seroconversion (p=0.008), possibly due to mycophenolate-enhanced exposure and a younger age. Overall, children after kidney transplantation demonstrated a good serologic response to the inactivated influenza vaccine although somewhat lower than controls. Steroid-free immunosuppression did not seem to present an advantage in antibody response. Data on inactivated influenza vaccine safety and efficacy was collected and demonstrated absence of acute rejection or laboratory-proven influenza for 6 months postvaccination.
authors.affiliation: Section of Pediatric Nephrology and Hypertension, J.W. Riley Hospital for Children, Indiana University, Indianapolis, IN 46202, USA. cnailesc@iupui.edu
authors.forename: Corina
authors.initials: C
authors.lastname: Nailescu
authors.forename: Xiyan
authors.initials: X
authors.lastname: Xu
authors.forename: Hong
authors.initials: H
authors.lastname: Zhou
authors.forename: Henrietta
authors.initials: H
authors.lastname: Hall
authors.forename: Amy C
authors.initials: AC
authors.lastname: Wilson
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Leiser
authors.forename: Deepa H
authors.initials: DH
authors.lastname: Chand
authors.forename: Rudolph P
authors.initials: RP
authors.lastname: Valentini
authors.forename: Diane
authors.initials: D
authors.lastname: Hebert
authors.forename: John D
authors.initials: JD
authors.lastname: Mahan
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D002170:Canada; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D007115:Immunization Schedule; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D007251:Influenza, Human / Q000517:prevention & control* / Q000821:virology; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D000914:Antibodies, Viral; D007166:Immunosuppressive Agents; D007252:Influenza Vaccines; D013256:Steroids