Revaccination of adult patients following allogeneic haematopoietic stem cell transplantation: Cell recommendations
Abstract
Allogenic haematopoietic stem cell transplantation is associated with a significant alteration of the immune functions and patients after haematopoietic stem cell transplant are at high risk of infectious complications that are associated with significant mortality. Increased susceptibility to infections is caused by many factors such as an immature immune system during the first months after transplantation or functional hyposplenism.
Gradual decrease of specific antibodies in most patients with loss of specific immunity acquired in childhood following a vaccination series has also been described. Revaccination after haematopoietic stem cell transplantation is a widely accepted practice for preventing these risks.
Patients are indicated for revaccination with inactivated vaccines against Streptococcus pneumoniae, Neisseria menin-gitidis, Haemophilus influenzae type B, pertussis, tetanus, diphtheria, poliomyelitis, influenza and hepatitis B and with live vaccines against measles, rubella, mumps in some cases. Vaccination with inactivated vaccines is initiated according to current recommendations as early as 3 months after transplantation for some types of vaccines.
For most vaccines, vaccination consists of 2 to 3 doses 1-2 months apart. Vaccination with live antiviral vaccines is only indicated in selected patients and starts not sooner than 24 months after transplantation.
This article presents specific recommendations for vaccination and an overall summary of this topic based on current international recommendations for revaccination of haematopoietic transplant patients. (C) 2019, Czech Medical Association J.E. Purkyne.
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