Early experience with varicella vaccination in pediatric heart transplant recipients

International consensus guidelines to vaccinate children after solid organ transplant with the live-attenuated varicella (VZV) vaccine exclude pediatric heart transplant recipients due to insufficient evidence for safety, seroconversion rate, or adverse event profile. Caution is also recommended in...

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Bibliographic Details
Published inThe Journal of heart and lung transplantation Vol. 41; no. 8; pp. 1023 - 1026
Main Authors Dipchand, Anne I., Seifert-Hansen, Mirna
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.08.2022
Subjects
immunosuppression
live virus vaccine
pediatric heart transplantation
vaccination
varicella
immunosuppression
live virus vaccine
pediatric heart transplantation
varicella
vaccination
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Summary:International consensus guidelines to vaccinate children after solid organ transplant with the live-attenuated varicella (VZV) vaccine exclude pediatric heart transplant recipients due to insufficient evidence for safety, seroconversion rate, or adverse event profile. Caution is also recommended in the setting of mycophenolate mofetil (MMF) immunosuppression. However, VZV infection in these patients can be serious or even fatal. We report our novel early experience with VZV vaccination in a cohort of 31 children following heart transplantation, 42% of who were on MMF. The early seroconversion rate was 16/17 (94%) with no major adverse events. Though a rash of some description was reported in 29%, spots were few and self-resolving in 1-3 days. Select pediatric heart transplant patients can be safely vaccinated with VZV vaccine with a high early seroconversion rate and a mild adverse event profile.
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ISSN:1053-2498
1557-3117
DOI:10.1016/j.healun.2022.02.004