Vaccination Status of Pneumococcal and Other Vaccines in 444 Liver Transplant Patients Compared to a Representative Population Sample

Studies have documented deficits of pneumococcal and other vaccinations in kidney and lung transplant patients, but the vaccination status of liver transplant (LT) recipients is unknown. This cross-sectional study investigated the prevalence of immunizations among LT patients at a large university medical center compared to a representative general population sample.In 2014, all LT patients (>18 years of age) were asked for their vaccination documents. The immunization rates for pneumococcal and other vaccine-preventable diseases were calculated. LT patients' rates for tetanus, diphtheria, and polio vaccinations were compared to a national reference group. Because these vaccinations are recommended for both groups, pneumococcal and influenza vaccination rates of LT patients were compared to those of seniors (>65 years of age) from a national sample.We found that 444 of 581 LT patients (76.4%) had evaluable vaccination documents. Only 60% of the patients received at least 1 pneumococcal vaccination. Insufficient immunization rates (≥1 vaccination/lifetime prevalence) were also documented for other vaccine-preventable diseases: hepatitis B 64%, hepatitis A 48%, tetanus 87%, diphtheria 79%, polio 72%, pertussis 38%, and seasonal influenza (the preceding season) 51%. Only 0.7% (n=3) of LT patients had received all vaccinations as recommended. Similar deficits were documented in the national sample: tetanus 96%, diphtheria 82%, polio 86%, and pertussis 35%. LT patients received pneumococcal vaccines twice as frequently compared to seniors (60% vs. 31%), while influenza vaccination rates were comparable (51% vs. 45%).In agreement with studies addressing other solid organ transplant recipients, vaccination coverage of LT patients and the general population needs to be improved.