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Immunizations: Pre- and Post-transplantImmunizations or "baby shots" are very important for all children. They are the best available defense against many dangerous childhood diseases. Serious reactions to the recommended vaccines are rare in healthy children, but if your child has received an organ transplant, or is waiting for a transplant, special precautions will need to be taken. There are two main types of vaccines: the live attenuated vaccine and the killed or inactivated vaccine. Live attenuated vaccines are actual viruses that are too weak to cause disease in people with normal immune systems. When a person is vaccinated with the live attenuated virus, it causes an actual infection; however, the virus isn’t strong enough to make the person feel sick. Their immune system quickly conquers the virus. Cells that were generated to fight the virus remain in the vaccinated person’s system and if that person ever comes in contact with the same virus again, they are primed to respond. The virus is eliminated before the person ever begins to show symptoms. This person is now "immune" to that particular virus. Because transplant patients have suppressed immune systems, they may not be able to respond to a live vaccine normally. A live vaccine might actually be strong enough to cause the real disease. For this reason, live vaccines are not given to organ transplant patients. The other type of vaccine, the inactivated vaccine, is safe for transplant patients. It consists of only portions of the virus or organism and will not cause even the most severely immunosuppressed patient to develop an actual infection. Children with organ transplants are given the inactivated poliovirus vaccine (IPV) and never the live oral vaccine (OPV). The IPV vaccine is given by injection and is just as effective as the traditional oral polio. Unfortunately, there is no inactivated version of the MMR vaccine. Children who are transplanted before finishing both doses of the MMR vaccine (MMR #1 is given at 15 mos.; #2 at 4–6 yrs.) will have to rely on "herd immunity." This means that because most other people in the community have been vaccinated, their chance of ever being exposed to measles, mumps, or rubella will be minimal. Children may receive live vaccines prior to transplant, but they should wait a minimum of two months before they are transplanted. This will insure that the live vaccine has been completely eliminated from the child’s system prior to transplant. After transplant it is important to check with your coordinator before resuming your child’s vaccination schedule. Siblings of transplanted children should receive the inactivated polio injection and never the oral polio. The oral polio is shed in the stool for two weeks or longer and the vaccine virus can be passed to others through contact with the stool. This usually doesn’t pose a threat to anyone, but a transplant patient might get sick from the oral polio virus if they come into contact with the it (dirty diaper, etc.). Siblings may, however, receive the live MMR vaccine, which is given by injection and not shed in the stool. Acceptable vaccines post-transplant:
Vaccinations that should not be given post-transplant:
If at any time your transplanted child is exposed to measles, mumps,
chicken pox, or any other infectious disease, notify your transplant
team immediately.
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Children’s Liver Association for Support Services
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