Clinical Trial Demonstrates

Clinical Trial Demonstrates Safety and Effectiveness of Live Vaccinations for Liver and Kidney Transplant Recipients


A recent clinical trial has revealed that live vaccinations administered to children who have undergone liver or kidney transplants are safe and effective in stimulating an immune response against potentially life-threatening diseases. The study, published in JAMA Network Open, collected data from 18 organ transplant centers and was co-authored by Dr. Lara Danziger-Isakov, interim director of the Division of Infectious Diseases at Cincinnati Children’s, and Dr. Amy Feldman, medical director of the Liver Transplant Program at Children’s Hospital Colorado.

The findings of this study have significant implications, as the rates of diseases such as measles, mumps, and varicella-zoster virus (chickenpox) are increasing globally, placing immunocompromised children at a heightened risk of severe complications. Traditionally, immunocompromised individuals, including transplant recipients, have avoided live viral vaccines due to concerns about potential infection from the vaccine strain. However, this study challenges that perspective and paves the way for these children to have a greater sense of security and reduced risk of acquiring diseases like chickenpox and measles, which have recently experienced resurgences.

Dr. Feldman, the study’s first author, highlights that the COVID-19 pandemic has further exacerbated the global surge in measles and mumps due to a decline in herd immunity caused by missed vaccine doses. This has left organ transplant recipients, who are already vulnerable, at a significantly higher risk of exposure, infection, and potentially fatal complications from these diseases. Dr. Feldman emphasizes the importance of being able to administer live vaccines to this population to provide them with much-needed immunity.

Traditionally, live vaccines for measles, mumps, rubella (MMR), and varicella-zoster virus (VZV) have not been recommended for solid organ transplant recipients due to concerns about potential infection. However, the study reports no serious adverse events occurring in the children who received live vaccinations between January 1, 2002, and February 28, 2023.

The trial included 281 children on chronic immunosuppressive medications, with a median age of 8.9 years at the time of the first post-transplant vaccine. Participants received one to three doses of MMR vaccine and/or one to three doses of VZV vaccine. Safety data were collected after each vaccination, and antibody levels were measured at various intervals. The results showed that the majority of children developed protective antibodies against the targeted diseases following vaccination, and the majority maintained that protection after one year.

While these findings indicate that live vaccinations can be safe and effective for select pediatric organ transplant recipients, further research is needed to understand the long-term maintenance of immunity and the factors associated with immune response and clinical protection. However, these results offer hope for immunocompromised children and highlight the potential to protect them from circulating diseases through vaccination.

1. Source: Coherent Market Insights, Public sources, Desk research
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