Impact of a pharmacy driven vaccine program in abdominal organ transplant patients prior to transplant
Megan Sell1, Nagraj Kasi1, Mallory Huffstetler1, Katherine Twombley1.
1Pediatrics, Medical University of South Carolina, Charleston, SC, United States
Background: Vaccination history is typically reviewed prior to abdominal organ transplant (AOT: liver, kidney), but unfortunately, many patients have not received all of the recommended vaccinations.
Objective: Determine the efficacy of a pharmacy driven vaccination program on improved vaccine rates
Methods: The pediatric kidney and liver transplant clinics started a pharmacist driven vaccine administration program in November of 2019. Vaccines that are found to be deficient are either given during the evaluation clinic appointment or a letter is sent to the pediatrician asking them to administer the vaccines. We performed a retrospective review of the records to determine if this intervention was successful. Fulminant liver patient evaluations were excluded.
Results:
KIDNEY (19 patients): Patients had received an average of 81% (29-97%) of their eligible routine childhood vaccines at referral and no patients were completely up to date at time of referral. After intervention, patients received an average of 97% (89-100%) of their routine childhood vaccines at time of transplant; 10/19 patients (53%) were completely up to date at the time of transplant. Average number of vaccines received between referral date and transplant date were 5 vaccines (0-12). Average time between referral and transplant was 280 days (range 8-1106 days).
LIVER (14 patients):Patients had received an average of 79% (50-96%) of their eligible routine childhood vaccines at time of referral; no patients were completely up to date at time of referral. Patients received an average of 97% (91-100%) of their routine childhood vaccines at time of transplant; 6/14 patients (43%) were completely up to date at the time of transplant. Average number of vaccines received between referral date and transplant date were 7 vaccines (1-15). Average time between referral and transplant was 264 days (79-832 days)
Conclusion: Our pharmacy driven vaccine program greatly improved our vaccination rates prior to transplantation in both pediatric liver and kidney transplant patients. More work will need to be done to improve our rates further.
[1] Feldman AG, Curtis DJ, Moore SL, Kempe A. Under-immunization of pediatric transplant recipients: a call to action for the pediatric community. Pediatr Res. 2020;87(2):277-281.