Influenza Vaccination Is Efficacious and Safe in Renal Transplant Recipients

• Published in: American journal of transplantation Vol. 8; no. 2; pp. 332 - 337
• Main Authors: Scharpé, J., Evenepoel, P., Maes, B., Bammens, B., Claes, K., Osterhaus, A. D., Vanrenterghem, Y., Peetermans, W. E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-02-2008; Blackwell
• Subjects: Adult; Antibody Formation; Biological and medical sciences; Creatinine - blood; Female; Human viral diseases; Humans; Infectious diseases; Influenza; Influenza A Virus, H1N1 Subtype - immunology; Influenza A Virus, H3N2 Subtype - immunology; Influenza B virus - immunology; Influenza Vaccines - adverse effects; Kidney Transplantation - immunology; Male; Medical sciences; Middle Aged; Prevention and actions; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Reference Values; renal transplantation; Safety; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; vaccination; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; Vaccination; renal transplantation; Homotransplantation; Kidney; Infection; Prevention; Immunoprophylaxis; Treatment; Urinary system; Surgery; Viral disease; Influenza; Graft; Kidney transplantation
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2007.02066.x

Whether influenza vaccination in solid‐organ transplant recipients is efficacious remains a controversial issue. Furthermore, theoretical concerns have been raised regarding the safety of vaccination as it might trigger rejection of the allograft. The present prospective trial is aimed at investigating the antibody response and safety of influenza vaccination in renal transplant recipients (RTR).
A total of 165 RTR and 41 healthy volunteers were vaccinated with a standard trivalent inactivated influenza vaccine. Hemagglutination‐inhibiting (HI) antibodies were quantified before and 1 month after vaccination. Seroprotection (SP) and seroresponse (SR) were defined as a titer ≥40 and a 4‐fold rise in HI titer, respectively. Similar SR rates were observed in both groups. Postvaccination SP rates in RTR amounted to 92.7%, 78.7% and 82.9% for A/H1N1, A/H3N2 and B, respectively. High baseline SP rates, most probably reflecting frequent preimmunizations, explain partly the high postvaccination SP rates. SR rate was independently and inversely associated with baseline SP rate. Mycophenolate mofetil (MMF) usage was associated with a 2.6–5‐fold lower SR. Nonetheless, these patients showed good postvaccination SP rates. A booster dose did not enhance SP or SR rates. Influenza vaccination neither affected allograft function nor caused rejection episodes. In conclusion, influenza vaccination is efficacious and safe in renal transplantation.
Influenza vaccination in 165 renal transplant recipients resulted in seroprotection rates and seroresponse rates similar to those obtained in controls, without affecting allograft function. Seroresponse rates were lower with MMF usage and with low baseline seroprotection.