COVID‐19 vaccination in pediatric solid organ transplant recipients—Current state and future directions

Abstract

Background Population‐level COVID‐19 immunization will play a key role in slowing down the SARS‐CoV‐2 pandemic on a global scale and protect the most at‐risk individuals. Thanks to a formidable universal effort, several SARS‐CoV‐2 vaccines have been marketed less than a year since the first documented COVID‐19 case, with promising safety, efficacy, and immunogenicity results in adults. As children were not included in the initial trials, no vaccine is currently approved for individuals <16 years of age. Similarly, immunosuppressed individuals, such as solid organ transplant recipients, were excluded from initial vaccine trials, limiting the understanding of vaccine immunogenicity and safety in this at‐risk population. Thus, data regarding COVID‐19 vaccination in pediatric solid organ transplantation recipients are currently lacking. Methods Members of the International Pediatric Transplant Association review the current general status of COVID‐19 vaccines focusing on pediatric‐specific issues. Results This review provides an overview of COVID‐19 vaccines in pediatric SOT recipients and highlights the current paucity of data in both pediatric and transplant settings in terms of safety, immunogenicity, and clinical efficacy. Conclusions Vaccine trials including children and transplant recipients are underway and will be necessary to characterize COVID‐19 vaccine safety, immunogenicity, and efficacy, which will determine potential future research directions.

SARS‐CoV‐2 vaccination in solid‐organ transplant recipients: What the clinician needs to know

“…Albeit children and adolescents tend to have milder disease compared with adults, pediatric population with underlying conditions are more likely to experience severe COVID‐19 and might get benefits of full vaccination against SARS‐CoV‐2 alongside other priority groups for vaccination [ 82 ]. While no published data about SARS‐CoV‐2 vaccination among the pediatric population are available, several trials including pediatric population and pediatric SOT recipients are underway and should support update in the current recommendations.…”

Os desafios da pandemia e a vacinação covid-19 na população pediátrica com doenças renais

“…Considerando que a SHUa é uma doença grave, a mesma foi excluída dos ensaios clínicos de vacinas Pfizer-BioNTech, Moderna e AstraZeneca. Assim, não se sabe se as vacinas atualmente disponíveis são tão eficazes para esses pacientes quanto foram para a população do estudo 30,31 , e não há dados que sugiram que as vacinas disponíveis seriam menos eficazes ou menos seguras do que para a população em geral.…”

“…I) Vacinar todos os pacientes pediátricos com SHUa, seguindo os limites de idade estabelecidos pelas agências reguladoras; II) Crianças e adolescentes com histórico de reação alérgica grave a uma dose anterior de vacina ou a um de seus componentes não devem receber a vacina 31 ; III) Familiares dos pacientes com diagnóstico de SHUa devem fazer o esquema vacinal completo, sobretudo os familiares das crianças menores de 5 anos;…”

The COVID-19 pandemic in children and young people during 2020-2021: Learning about clinical presentation, patterns of spread, viral load, diagnosis and treatment

“…The paucity of data was also highlighted for pediatric solid organ transplant (SOT) recipients, with uncertainty over both the SARS-CoV-2 infection and the vaccination in terms of safety, immunogenicity, and vaccine efficacy. It was stressed that trials that would include pediatric SOT recipients are much needed and that some are already under way to fill this knowledge gap [ 123 ]. In Italy, paediatric oncology units reported on a cohort of 89 adolescent and young adult patients among whom 80 agreed to vaccination.…”