October 28, 2024, Immune Tolerance
In a previous WeChat post, the kidney transplant team at Zhongshan Hospital, affiliated with Fudan University, outlined the precautions kidney transplant recipients should take when receiving the flu vaccine. Many kidney patients have inquired about what precautions should be taken for other vaccines.
Today, Dr. Zhang provides a concise overview of vaccination for kidney transplant recipients.
The Primary Principle Is as Follows:
There is no direct evidence linking any type of vaccination to complications, such as rejection, following kidney transplantation. Nevertheless, due to chronic immunosuppression, live vaccines should be avoided after kidney transplantation. Because live vaccines contain live viral components, they can cause severe infections in transplant recipients, potentially becoming life-threatening. Therefore, after kidney transplantation, if you wish to receive a vaccine, you may only receive inactivated vaccines.
Regarding Vaccination Timing:
Pre-transplant: It is recommended that all live vaccines, including but not limited to measles, mumps, rubella, varicella, BCG, shingles, and influenza, be administered before kidney transplantation. However, it should be noted that at least 4 weeks must elapse after receiving a live vaccine before undergoing transplantation.
Post-transplant: Inactivated vaccines that can be administered after kidney transplantation include, but are not limited to, hepatitis A, pertussis, diphtheria, tetanus, Streptococcus pneumoniae, and influenza, among others. However, these should be administered at least 3 months post-transplant, once kidney function has stabilized.
Other Cases: Specific inactivated vaccines may need to be administered after kidney transplantation if there is exposure to particular risk factors or a risk of exposure, such as dog bites. These include, but are not limited to, the rabies vaccine, Neisseria meningitidis vaccine, inactivated Japanese encephalitis vaccine, and inactivated Salmonella typhi vaccine, among others. These are the fundamental aspects of vaccination for kidney transplant patients, and I hope this provides you with a general understanding of the topic. Finally, it must be emphasized that, both before and after kidney transplantation, vaccination should only be conducted under the joint guidance of the transplant physician and a preventive medicine specialist from the relevant infectious disease department.
References:
1.UpToDate: Camille N. Kotton, Patricia L. Hibberd. Immunizations in Solid Organ Transplant Candidates and Recipients. Sep 27, 2019.
2.L. Danziger-Isakov, D. Kumar, and the AST Infectious Diseases Community of Practice. Guidelines for Vaccination of Solid Organ Transplant Candidates and Recipients. American Journal of Transplantation 2009; 9 (Suppl 4): S258–S262.
Written by | Zhang Weitao, Illustrations | Lily
This article is an original publication of the “Kidney Transplantation, Zhongshan Hospital, Fudan University” WeChat public account. Reproduction requires authorization from this account and the original author, with proper attribution. To care for your kidneys, begin by following the “Kidney Transplantation, Zhongshan Hospital, Fudan University” WeChat public account. You can also click [Read the Original] to explore “The Story of Mesenchymal Stem Cells and Renal Fibrosis (Part 4).”
