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Multimodal safety assessment of measles-mumps-rubella vaccination after pediatric liver transplantation

Rodriguez, Maria
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Published in American journal of transplantation. 2019, vol. 19, no. 3, p. 844-854
Abstract Live-attenuated vaccines are currently contraindicated in solid-organ transplant recipients. However, the risk of vaccine-preventable infections is lifelong, and can be particularly severe after transplantation. In this prospective interventional national cohort study, 44 pediatric liver transplant recipients with measles IgG antibodies <150 IU/L (below seroprotection threshold) received measles-mumps-rubella vaccine (MMR) at a median of 6.3 years posttransplantation (interquartile range, 4.0 to 10.9). A maximum of two additional doses were administered in nonresponders or when seroprotection was lost. Vaccine responses occurred in 98% (95% confidence interval [CI], 88-100) of patients. Seroprotection at 1-, 2-, and 3-year follow-up reached 62% (95% CI, 45-78), 86% (95% CI, 70-95), and 89% (95% CI, 67-99), respectively. All patients responded appropriately to the booster dose(s). Vaccinations were well tolerated and no serious adverse event attributable to vaccination was identified during the 8-week follow-up period (or later), using a multimodal approach including standardized telephone interviews, diarized side effect reporting, and monitoring of vaccinal virus shedding. We conclude that live attenuated MMR vaccine can be administered in liver transplant recipients fulfilling specific eligibility criteria (>1 year posttransplantation, low immunosuppression, lymphocyte count ≥0.75 G/L), inducing seroprotection in most subjects. (Clinicaltrials.gov number NCT01770119).
Keywords Clinical research/practiceClinical trialInfection and infectious agents—viralInfectiousDiseaseLiver transplantation/hepatologyPediatricsVaccine
PMID: 30171797
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Research groups Centre de vaccinologie et d'immunologie néonatale (177)
Développement du tube digestif chez les vertébrés (900)
Groupe Laurent Kaiser (virologie clinique) (668)
Recherche clinique en chirurgie pédiatrique (886)
Recherche en infectiologie pédiatrique et en pédiatrie générale (853)
(ISO format)
PITTET, Laure et al. Multimodal safety assessment of measles-mumps-rubella vaccination after pediatric liver transplantation. In: American Journal of Transplantation, 2019, vol. 19, n° 3, p. 844-854. doi: 10.1111/ajt.15101 https://archive-ouverte.unige.ch/unige:116830

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Deposited on : 2019-05-02

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