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1755. Assessment of Vaccine Rates in Solid-Organ Transplant Recipients and Identification of factors Associated with Completion of Vaccination

BACKGROUND: Vaccine administration is an essential component of pre and post-transplant care. Although Society guidelines for vaccination of solid-organ transplant recipients (SOT) are published, rates of vaccination remain low and potential factors influencing these rates are not well identified. M...

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Detalles Bibliográficos
Autores principales: Parraga Acosta, Tommy J, Hanna, Zachary W, Daering, Nicholas J, Vahia, Amit T, Alangaden, George J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809305/
http://dx.doi.org/10.1093/ofid/ofz360.1618
Descripción
Sumario:BACKGROUND: Vaccine administration is an essential component of pre and post-transplant care. Although Society guidelines for vaccination of solid-organ transplant recipients (SOT) are published, rates of vaccination remain low and potential factors influencing these rates are not well identified. METHODS: A retrospective review of electronic medical records (EMR) was done for all adult SOT patients who underwent transplantation from January 2015 to December 2016 at Henry Ford Hospital, Detroit, MI. Sociodemographic data, comorbidities, and vaccination status at 1-year post-SOT for influenza, pneumococcus, hepatitis A and B, Tdap, and Td vaccines were assessed from EMR and the Michigan Care Improvement Registry. Data were analyzed using SAS 9.4 software, univariate analysis was done with Chi-square test, t-test, and multivariate analysis with logistic regression. RESULTS: 530 patients underwent SOT during the study period. Characteristics of the study population are shown (Table 1). The median age was 59, mean Charlson Comorbidity Index was 5.25, 58.3% had smoking history. At 1-year post SOT, 88.7% had received ≥1 vaccine(s), whereas 11.3% received no vaccines. Most patients received vaccines before SOT. Influenza (69.4%) and pneumococcal (69.3%) vaccines were the most administered (Table 2). On univariate analysis, pre-SOT visits with a primary care provider (PCP), transplant team or PCP based at our institution were significantly associated with vaccination (Table 3). On multivariate analysis, PCP based at our institution (odds ratio [OR], 2.03 [95% confidence interval {CI}, [1.06–3.88], P = 0.033) and pre-SOT PCP visits (OR 1.47, [95% CI 1.11–1.96], P = 0.008) were significantly associated with vaccine uptake. Smoking history negatively impacted vaccine uptake (Table 4). Patients who had received the influenza vaccine(s) were significantly associated with increased uptake of other vaccines (P < 0.0001). CONCLUSION: Despite guidelines, vaccination rates in SOT patients remain low at our institution. Factors associated with improved vaccination were institution-based PCP, pre-SOT PCP visits and receipt of influenza vaccines. A multidisciplinary approach is required for the optimization of vaccination rates in the SOT population. [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.