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Influenza vaccine after pediatric kidney transplant: a Midwest Pediatric Nephrology Consortium study

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Abstract

The main aim of this study was to compare the response to trivalent inactivated influenza vaccine in children who received a kidney transplant and were on steroid-free versus steroid-based immunosuppression. Groups: 1. Kidney transplant recipients on steroid-free immunosuppression (n = 27); 2. Kidney transplant recipients on steroid-based immunosuppression (n = 39); 3. Healthy controls (n = 21). Hemagglutination inhibition titers against 2007–2008 A/H1N1 and A/H3N2 and B strains were measured before and 8 weeks postvaccination. Postvaccination geometric mean titers to A/H1N1 were significantly lower among both transplant groups than controls (p = 0.025 and 0.015, respectively). Postvaccination titers to H3N2 and B strains were not statistically different between groups. Proportions of participants developing seroprotection were not different among groups. Both kidney transplant groups seroconverted less than controls for A/H1N1 (p = 0.0002) and were no different from controls for B. For A/H3N2, the steroid-free group had the weakest seroconversion (p = 0.008), possibly due to mycophenolate-enhanced exposure and a younger age. Overall, children after kidney transplantation demonstrated a good serologic response to the inactivated influenza vaccine although somewhat lower than controls. Steroid-free immunosuppression did not seem to present an advantage in antibody response. Data on inactivated influenza vaccine safety and efficacy was collected and demonstrated absence of acute rejection or laboratory-proven influenza for 6 months postvaccination.

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References

  1. Harper SA, Fukuda K, Uyeki TM, Cox NJ, Bridges CB (2004) Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 53:1–40

    PubMed  Google Scholar 

  2. Hilleman MR (2002) Realities and enigmas of human viral influenza: pathogenesis, epidemiology and control. Vaccine 20:3068–3087

    Article  PubMed  Google Scholar 

  3. HM WEK (1999) Basic Virology. Blackwell Science, Malden, MA

    Google Scholar 

  4. American Academ of Pediatrics, Committee on Infectious Diseases (2004) Recommendations for influenza immunization of children. Pediatrics 113:1441–1447

    Article  Google Scholar 

  5. Neuzil KM, Zhu Y, Griffin MR, Edwards KM, Thompson JM, Tollefson SJ, Wright PF (2002) Burden of interpandemic influenza in children younger than 5 years: a 25-year prospective study. J Infect Dis 185:147–152

    Article  PubMed  Google Scholar 

  6. Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR (2000) The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. New Eng J Med 342:225–231

    Article  PubMed  CAS  Google Scholar 

  7. Izurieta HS, Thompson WW, Kramarz P, Shay DK, Davis RL, DeStefano F, Black S, Shinefield H, Fukuda K (2000) Influenza and the rates of hospitalization for respiratory disease among infants and young children. New Eng J Med 342:232–239

    Article  PubMed  CAS  Google Scholar 

  8. Glezen WP (1996) Emerging infections: pandemic influenza. Epidemiol Rev 18:64–76

    PubMed  CAS  Google Scholar 

  9. Vilchez RA, Fung J, Kusne S (2002) The pathogenesis and management of influenza virus infection in organ transplant recipients. Transpl Infect Dis 4:177–182

    Article  PubMed  CAS  Google Scholar 

  10. Vilchez RA, McCurry K, Dauber J, Lacono A, Griffith B, Fung J, Kusne S (2002) Influenza virus infection in adult solid organ transplant recipients. Am J Transplant 2:287–291

    Article  PubMed  Google Scholar 

  11. No authors listed (2004) Guidelines for vaccination of solid organ transplant candidates and recipients. Am J Transplant 4(Suppl 10):160–163

    Google Scholar 

  12. Blumberg EA, Fitzpatrick J, Stutman PC, Hayden FG, Brozena SC (1998) Safety of influenza vaccine in heart transplant recipients. J Heart Lung Transplant 17:1075–1080

    PubMed  CAS  Google Scholar 

  13. Noble GR, Kaye HS, Yarbrough WB, Fiedler BK, Reed CJ, Felker MB, Kendal AP, Dowdle WR (1977) Measurement of hemagglutination-inhibiting antibody to influenza virus in the 1976 influenza vaccine program: methods and test reproducibility. J Infect Dis 136(Suppl):S429–S434

    Article  PubMed  Google Scholar 

  14. Talbot HK, Keitel W, Cate TR, Treanor J, Campbell J, Brady RC, Graham I, Dekker CL, Ho D, Winokur P, Walter E, Bennet J, Formica N, Hartel G, Skeljo M, Edwards KM (2008) Immunogenicity, safety and consistency of new trivalent inactivated influenza vaccine. Vaccine 26:4057–4061

    Article  PubMed  CAS  Google Scholar 

  15. Keitel WA, Cate TR, Couch RB, Huggins LL, Hess KR (1997) Efficacy of repeated annual immunization with inactivated influenza virus vaccines over a five year period. Vaccine 15:1114–1122

    Article  PubMed  CAS  Google Scholar 

  16. Berben L, Denhaerynck K, Schaub S, De Geest S (2009) Prevalence and correlates of influenza vaccination among kidney transplant patients. Prog Transplant 19:312–317

    PubMed  Google Scholar 

  17. Mauch TJ, Crouch NA, Freese DK, Braunlin EA, Dunn DL, Kashtan CE (1995) Antibody response of pediatric solid organ transplant recipients to immunization against influenza virus. J Pediatr 127:957–960

    Article  PubMed  CAS  Google Scholar 

  18. Furth SL, Neu AM, McColley SA, Case B, Steinhoff M, Fivush B (1995) Immune response to influenza vaccination in children with renal disease. Pediatr Nephrol (Berlin, Germany) 9:566–568

    Article  CAS  Google Scholar 

  19. Edvardsson VO, Flynn JT, Deforest A, Kaiser BA, Schulman SL, Bradley A, Palmer J, Polinsky MS, Baluarte HJ (1996) Effective immunization against influenza in pediatric renal transplant recipients. Clin Transplant 10:556–560

    PubMed  CAS  Google Scholar 

  20. Mack DR, Chartrand SA, Ruby EI, Antonson DL, Shaw BW Jr, Heffron TG (1996) Influenza vaccination following liver transplantation in children. Liver Transpl Surg 2:431–437

    Article  PubMed  CAS  Google Scholar 

  21. Salles MJ, Sens YA, Boas LS, Machado CM (2009) Influenza virus vaccination in kidney transplant recipients: serum antibody response to different immunosuppressive drugs. Clin Transplant 24:E17–E23

    Article  PubMed  Google Scholar 

  22. Ettenger R, Sarwal MM (2005) Mycophenolate mofetil in pediatric renal transplantation. Transplantation 80:S201–S210

    Article  PubMed  CAS  Google Scholar 

  23. Neuzil KM, Dupont WD, Wright PF, Edwards KM (2001) Efficacy of inactivated and cold-adapted vaccines against influenza A infection, 1985 to 1990: the pediatric experience. Pediatr Infect Dis J 20:733–740

    PubMed  CAS  Google Scholar 

  24. Scharpe J, Evenepoel P, Maes B, Bammens B, Claes K, Osterhaus AD, Vanrenterghem Y, Peetermans WE (2008) Influenza vaccination is efficacious and safe in renal transplant recipients. Am J Transplant 8:332–337

    Article  PubMed  CAS  Google Scholar 

  25. Negri E, Colombo C, Giordano L, Groth N, Apolone G, La Vecchia C (2005) Influenza vaccine in healthy children: a meta-analysis. Vaccine 23:2851–2861

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was funded by the National Kidney Foundation of Indiana. The authors are extremely grateful to Dr. Nancy Cox (Director, Influenza Division, WHO Collaborating Center for the Surveillance, Epidemiology and Control of Influenza Center for Disease Control and Prevention, Atlanta, GA, USA), in whose laboratory the HAI antibody titer assays have been performed, as well as to Dr. Alexander Klimov, Branch Chief, and Dr. Carolyn Bridges, Associate Director of the Division at the same institution, for their support, and to Amanda Balish for technical assistance. In addition, we thank Dr. John Christenson, Professor of Clinical Pediatrics and Director of Infectious Disease Division from J.W. Riley Hospital for Children for his expert advice in pediatric infectious diseases, Dr. Sharon P. Andreoli, Professor of Pediatrics and Director, Section of Pediatric Nephrology and Hypertension from J.W. Riley Hospital for Children for her invaluable input, and at last but not the least, Bethanne Johnston, MSN, CPNP for her diligent work in coordinating the study.

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Authors and Affiliations

  1. Section of Pediatric Nephrology and Hypertension, J.W. Riley Hospital for Children, Indiana University, Indianapolis, IN, USA

    Corina Nailescu, Amy C. Wilson & Jeffrey D. Leiser

  2. Influenza Division, World Health Organization Collaborating Center for the Surveillance, Epidemiology and Control of Influenza, Center for Disease Control and Prevention, Atlanta, GA, USA

    Xiyan Xu, Hong Zhou & Henrietta Hall

  3. Atlanta Research and Education Foundation, Atlanta, GA, USA

    Hong Zhou

  4. Division of Pediatric Nephrology, Children’s Hospital of Akron, Akron, OH, USA

    Deepa H. Chand

  5. Division of Pediatric Nephrology, Children’s Hospital of Michigan, Wayne State University, Detroit, MI, USA

    Rudolph P. Valentini

  6. Division of Pediatric Nephrology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

    Diane Hebert

  7. Division of Pediatric Nephrology, Nationwide Children’s Hospital, Ohio State University, Columbus, OH, USA

    John D. Mahan

  8. Division of Pediatric Nephrology, J.W. Riley Hospital for Children, Indiana University, 699 Riley Hospital Drive, Riley Research Building Room 230, Indianapolis, IN, 46202, USA

    Corina Nailescu

Authors
  1. Corina Nailescu
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  2. Xiyan Xu
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  3. Hong Zhou
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  4. Henrietta Hall
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  5. Amy C. Wilson
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  6. Jeffrey D. Leiser
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  7. Deepa H. Chand
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  8. Rudolph P. Valentini
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  9. Diane Hebert
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  10. John D. Mahan
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Corresponding author

Correspondence to Corina Nailescu.

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Fig. E1

Comparison between tacrolimus and cyclosporine levels and mycophenolate doses between the steroid-free and steroid-based groups (DOC 26 kb)

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Nailescu, C., Xu, X., Zhou, H. et al. Influenza vaccine after pediatric kidney transplant: a Midwest Pediatric Nephrology Consortium study. Pediatr Nephrol 26, 459–467 (2011). https://doi.org/10.1007/s00467-010-1729-1

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  • DOI: https://doi.org/10.1007/s00467-010-1729-1

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