Deficient Long-Term Response to Pandemic Vaccine Results in An Insufficient Antibody Response to Seasonal Influenza Vaccination in Solid Organ Transplant Recipients

Influenza vaccination in solid-organ transplant recipients

“…In a prospective multicenter study, the seroprotection rate of adjuvanted influenza A(H1N1)pdm vaccine did not differ between patients vaccinated 2-6 months as compared to more than 6 months after transplant [7 & ]. Another study, carried out during 2010-2011 influenza season, showed similar results [68]. No cases of graft rejection were reported in any of these studies.…”

“…Detectable titers of influenza antibodies before vaccination seem to correlate with higher antibody responses postvaccination [68]. A booster dose given some weeks after the standard dose may elicit a longlasting antibody response, therefore producing a better protection in current and subsequent influenza seasons.…”

Humoral, T-cell and B-cell immune responses to seasonal influenza vaccine in solid organ transplant recipients receiving anti-T cell therapies

“…This is most likely due to a high number of patients having detectable antibodies pre-vaccination, reflecting previous use of influenza vaccine in our patient cohort [30,34,35]. After taking into consideration the pre-vaccination titers [28], seroconversion rates increased up to 32-38% for influenza A strains, a rate near of the 40% seroconversion rate which is considered as appropriate for the general population [9,36].…”

Impact of Immunosuppression on Recall Immune Responses to Influenza Vaccination in Stable Renal Transplant Recipients

“…Previous studies have identified mycophenolate mofetil (MMF) to be most effective in reducing serological responses to influenza vaccination (3, 7–12). However, MMF doses in the transplant cohort were relatively consistent, ranging from 1,000 to 1,500 mg/day, thus future studies involving a larger cohort of patients receiving a larger range of doses of MMF will allow us to more fully determine whether MMF doses higher than in stable renal transplant recipients correlate with the magnitude of the influenza-specific ASC response.…”

“…Nonetheless, concerns regarding the efficacy of vaccination in transplant recipients on chronic immunosuppression (7–13) as well as the possibility that the vaccination could trigger rejection episodes (14–16) are most frequently cited as reasons to not vaccinate (4). Vaccine responses are assessed by hemagglutination-inhibition or microneutralization antibody titers post-immunization (17, 18), and there is considerable variability in the reported overall seroconversion rates in transplant recipients, which could be a result of heterogeneity in the individual response to the vaccine, immunosuppression regimen, or both (3, 13, 19–22).…”