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Pediatr Nephrol. 2018 Feb;33(2):341-350. doi: 10.1007/s00467-017-3776-3. Epub 2017 Oct 5.

Incomplete vaccination coverage in European children with end-stage kidney disease prior to renal transplantation.

Author information

1
Department of Paediatrics I, University Children's Hospital, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany.
2
Department of Infectious Diseases, Virology, University Hospital Heidelberg, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany.
3
Hanover Medical School, Carl-Neuberg-Strasse 1, 30625, Hanover, Germany.
4
IRCCS Ospedale Pediatrico Bambino Gesù, Piazza di Sant'Onofrio 4, 00165, Rome, Italy.
5
Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, M13 9WL, Manchester, UK.
6
Clinic of Stuttgart, Olga Children's Hospital, Kriegsbergstrasse 62, 70174, Stuttgart, Germany.
7
Paediatric Nephrology Department, Ondokuz Mayis University Faculty of Medicine, Children's Hospital, Kurupelit, 55139, Samsun, Turkey.
8
University Children's Hospital, Hoppe-Seyler-Strasse 1, 72076, Tübingen, Germany.
9
Department of General Paediatrics, Paediatric Nephrology, University Children's Hospital, Waldeyerstrasse 22, 48149, Münster, Germany.
10
University Children's Hospital, Hufelandstrasse 55, 45122, Essen, Germany.
11
University Children's Hospital, Martinistrasse 52, 20246, Hamburg, Germany.
12
Department of Paediatric Nephrology, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Foundation Trust, WC1N 3JH, London, UK.
13
Department of General Pediatrics, Adolescent Medicine and Neonatology, Center for Pediatrics, Medical Center, Faculty of Medicine, University of Freiburg, Mathildenstrasse 1, 79106, Freiburg, Germany.
14
Paediatric Nephrology, University Children's Hospital, Ernst-Heydemann-Strasse 8, 18057, Rostock, Germany.
15
Department of Paediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
16
Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany.
17
Department of Paediatrics I, University Children's Hospital, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany. burkhard.toenshoff@med.uni-heidelberg.de.

Abstract

BACKGROUND:

Because infections constitute a major cause of morbidity and mortality in paediatric renal allograft recipients, avoidance of preventable systemic infections by vaccination before transplantation is of utmost importance. However, data on the completeness of vaccinations and factors associated with incomplete vaccination coverage are scarce.

METHODS:

Within the framework of the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN), we therefore performed a multi-centre, multi-national, retrospective study investigating the vaccination coverage before transplantation of 254 European children with end-stage renal disease (mean age 10.0 ± 5.6 years).

RESULTS:

Only 22 out of 254 patients (8.7%) presented complete vaccination coverage. In particular, the respective vaccination coverage against human papillomavirus (27.3%), pneumococci (42.0%), and meningococci (47.9%) was low. Patients with complete pneumococcal vaccination coverage had numerically less lower respiratory tract infections during the first 3 years post-transplant than children without vaccination or with an incomplete status (16.4% vs 27.7%, p = 0.081). Vaccine-preventable diseases post-transplant were 4.0 times more frequently in unvaccinated than in vaccinated patients. Factors associated with an incomplete vaccination coverage were non-Caucasian ethnicity (OR 9.21, p = 0.004), chronic dialysis treatment before transplantation (OR 6.18, p = 0.001), and older age at transplantation (OR 1.33, p < 0.001).

CONCLUSIONS:

The vaccination coverage in paediatric kidney transplant candidates is incomplete. Paediatric nephrologists, together with primary-care staff and patients' families, should therefore make every effort to improve vaccination rates before kidney transplantation.

KEYWORDS:

End-stage kidney disease; Paediatric transplant candidate; Post-transplant lower respiratory tract infections; Renal transplantation; Vaccination

PMID:
28983694
DOI:
10.1007/s00467-017-3776-3

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