Difficulties in the revaccination program of hematopoietic stem cell transplantation recipients

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Paula Moreira da Silva, Élen Monteiro da Silva, Anderson João Simioni, Mair Pedro de Souza, Vergílio Antonio Rensi Colturato, Clarisse Martins Machado
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2017
• Subjects: Hematopoietic stem cell transplantation; Immunization; Difficulties in revaccination; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/s1678-9946201759069; https://doaj.org/article/2605303fe0244484bc8c3dc5f2942837

ABSTRACT Hematopoietic stem cell transplant (HSCT) recipients should be routinely revaccinated after transplantation. We evaluated the difficulties met in the revaccination program and how a prospective and tailored follow-up could help to overcome these obstacles. HSCT recipients (n=122) were prospectively followed up and categorized into Group 1 (n=72), recipients who had already started the revaccination program, and Group 2 (n=50), recipients starting their vaccines. Whenever a difficulty was reported, interventions and subsequent evaluations were performed. Reported problems were related to patient compliance, HSCT center and/or vaccination center. Problems related to patient compliance were less frequent than those related to HSCT center modifications of previous recommendations, or to errors made by the vaccination center. The main gap found was vaccination delays (81.9%). Advisory intervention was needed in 64% and 46% of Group 1 and Group 2, respectively (p=0.05), and was partially successful in around 70% of the cases. Total resolution was achieved in more than 35% in both groups. Improvements are needed in the Brazilian vaccination program for HSCT recipients to assure a complete and updated revaccination schedule. HSCT centers should assign nurses and transplant infectious disease specialist physicians to organize the revaccination schedule and to monitor the program development.