Table 3.
Recommended vaccine schedule in adult solid organ transplant recipients
| Plan | Comment | ||
|---|---|---|---|
| Evaluation | Vaccination plan | ||
| Pre-transplant | Serologic test for measles IgG | MMR if seronegative | MMR should be completed at least I month prior to transplantation (not recommended if emergency listing for transplant within 4 weeks) |
| Mumps IgG | |||
| Rubella IgG | |||
| HAV IgG | HAV vaccine as schedule | 2 doses, 0, 1 month (titer follow up needed) | |
| HBsAb | HBV vaccine as schedule | 3 doses, 0, 1, 6-12 months (titer follow up needed) | |
| Varicella IgG | Varicella vaccine if seronegative | Varicella should be completed at least I month prior to transplantation (not recommended if emergency listing for transplant within 4 weeks) | |
| Herpes zoster | Possible | Contraindication in patients with previous varicella vaccinated or varicella naïve | |
| No need for serologic test, check vaccine history | Tdap (if no history of Tdap with 10 years) | Age of <64, first dose of Tdap, then Td every 10 years | |
| Pneumococcal vaccines | PCV13 1 dose followed by a dose of PPSV23 at least 8 weeks later | ||
| Post-transplant | Serologic test for HAV, HBV | HAV, HBV if needed | Same as pre-transplant periods |
| Vaccine start 2-6 months after transplant except annual influenza | |||
| Catch-up vaccination according to vaccine history and serology | Tdap (or Td) | Age of <64, first dose of Tdap, then Td every 10 years | |
| Pneumococcal vaccine | PCV13 1 dose followed by a dose of PPSV23 at least 8 weeks later if PPSV23 vaccinated first, can re-vaccine PPSV23 at least 5 years later or PCV13 at least 1 year later if high risk for pneumococcal infection (limited dat | ||
| Herpes zoster | Contraindication | ||
| Annual vaccine | Influenza | Live influenza vaccine is contraindication, others are strongly recommended | |
| Special vaccination | Meningococcal disease | Splenic dysfunction, conjugate vaccine is preferred | |
| HPV | Recommended but limited data | ||
| Haemophilus influenza type B (Hib) | Not recommended routine adult SOT recipients | ||
| Yellow fever | Contraindication | ||
MMR, measles, mumps, and rubella vaccine; HAV, hepatitis A virus; HBsAb, hepatitis B surface antibody; HBV, hepatitis B virus; Tdap, tetanus, diphtheria toxoid, and pertussis vaccine; Td, tetanus-diphtheria vaccine; PCV13, pneumococcal conjugate 13-valent vaccine; PPSV23, pneumococcal polysaccharide 23-valent vaccine; HPV, human papillomavirus; SOT, solid organ transplant.