Vaccine-Preventable Infections Among Solid Organ Transplant Recipients in Switzerland.
Details
Serval ID
serval:BIB_8F026B83CBA0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Vaccine-Preventable Infections Among Solid Organ Transplant Recipients in Switzerland.
Journal
JAMA network open
Working group(s)
Swiss Transplant Cohort Study
Contributor(s)
Amico P., Aubert J.D., Banz V., Beckmann S., Beldi G., Berger C., Berishvili E., Berzigotti A., Binet I., Bochud P.Y., Branca S., Bucher H., Catana E., Cairoli A., Chalandon Y., De Geest S., De Rougemont O., De Seigneuex S., Dickenmann M., Dreifuss J.L., Duchosal M., Fehr T., Ferrari-Lacraz S., Garzoni C., Golshayan D., Goossens N., Haidar F., Halter J., Heim D., Hess C., Hillinger S., Hirsch H.H., Hirt P., Hofbauer G., Huynh-Do U., Immer F., Koller M., Laager M., Laesser B., Lamoth F., Lehmann R., Leichtle A., Manuel O., Marti H.P., Martinelli M., McLin V., Mellac K., Mercay A., Mettler K., Müller A., Müller N.J., Müller-Arndt U., Müllhaupt B., Nägeli M., Oldani G., Pascual M., Passweg J., Pazeller R., Posfay-Barbe K., Rick J., Rosselet A., Rossi S., Rothlin S., Ruschitzka F., Schachtner T., Schranz U., Schaub S., Scherrer A., Schnyder A., Schuurmans M., Schwab S., Sengstag T., Simonetta F., Stampf S., Steiger J., Stirnimann G., Stützinger U., Van Delden C., Venetz J.P., Villard J., Vionnet J., Wick M., Wilhelm M., Yerly P.
ISSN
2574-3805 (Electronic)
ISSN-L
2574-3805
Publication state
Published
Issued date
03/04/2023
Peer-reviewed
Oui
Editor
Amico P Aubert J. D. Banz V. Beckmann S. Beldi G. Berger C. Berishvili E. Berzigotti A. Binet I. Bochud P. Y. Branca S. Bucher H. Catana E. Cairoli A. Chalandon Y. De Geest S. De Rougemont O. De Seigneuex S. Dickenmann M. Dreifuss J. L. Duchosal M. Fehr T. Ferrari-Lacraz S. Garzoni C. Golshayan D. Goossens N. Haidar F. Halter J. Heim D. Hess C. Hillinger S. Hirsch H. H. Hirt P. Hofbauer G. Huynh-Do U. Immer F. Koller M. Laager M. Laesser B. Lamoth F. Lehmann R. Leichtle A. Manuel O. Marti H. P. Martinelli M. McLin V. Mellac K. Mercay A. Mettler K. Muller A. Muller N. J. Muller-Arndt U. Mullhaupt B. Nageli M. Oldani G. Pascual M. Passweg J. Pazeller R. Posfay-Barbe K. Rick J. Rosselet A. Rossi S. Rothlin S. Ruschitzka F. Schachtner T. Schranz U. Schaub S. Scherrer A. Schnyder A. Schuurmans M. Schwab S. Sengstag T. Simonetta F. Stampf S. Steiger J. Stirnimann G. Stutzinger U. Van Delden C. Venetz J. P. Villard J. Vionnet J. Wick M. Wilhelm M. Yerly P., Swiss Transplant Cohort Study
Volume
6
Number
4
Pages
e2310687
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
Vaccine responses are decreased in solid organ transplant (SOT) recipients, and given the complexity of implementation, vaccination programs may be suboptimal. The actual burden of vaccine-preventable infections (VPIs) among SOT recipients remains unclear.
To assess the incidence rate of VPIs among SOT recipients and to evaluate whether SOT recipients are at increased risk for specific VPIs compared with the general population.
This nationwide cohort study used data from the Swiss Transplant Cohort Study on VPIs in individuals who underwent SOT from May 2008 to June 2019 (follow-up until December 2019) and data from the Swiss Federal Office of Public Health on notifiable VPIs in the general population in the same period. Data were analyzed from January 2021 to June 2022.
Solid organ transplant.
The main outcomes were the incidence rate of the following VPIs in SOT recipients: hepatitis A and B, diphtheria, Haemophilus influenzae infection, influenza, measles, mumps, pertussis, pneumococcal disease, poliomyelitis, meningococcal disease, rubella, tetanus, tick-borne encephalitis, and varicella zoster virus infection. Age-adjusted standardized incidence ratios were used to assess whether VPIs occurred more frequently in SOT recipients compared with the general population. For SOT recipients, factors associated with occurrence of VPIs were explored and the associated morbidity and mortality assessed.
Of 4967 SOT recipients enrolled (median age, 54 years [IQR, 42-62 years]; 3191 [64.2%] male), 593 (11.9%) experienced at least 1 VPI. The overall VPI incidence rate was higher in the population that underwent SOT (30.57 per 1000 person-years [PY]; 95% CI, 28.24-33.10 per 1000 PY) compared with the general population (0.71 per 1000 PY). The standardized age-adjusted incidence ratio for notifiable VPIs in SOT recipients was higher compared with the general population (27.84; 95% CI, 25.00-31.00). In SOT recipients, influenza and varicella zoster virus infection accounted for most VPI episodes (16.55 per 1000 PY [95% CI, 14.85-18.46 per 1000 PY] and 12.83 per 1000 PY [95% CI, 11.40-14.44 per 1000 PY], respectively). A total of 198 of 575 VPI episodes in the population that underwent SOT (34.4%) led to hospital admission, and the occurrence of a VPI was associated with an increased risk for death and/or graft loss (hazard ratio, 2.44; 95% CI, 1.50-3.99; P = .002). In multivariable analysis, age 65 years or older at the time of transplant (incidence rate ratio [IRR], 1.29; 95% CI, 1.02-1.62) and receipt of a lung (IRR, 1.77; 95% CI, 1.38-2.26) or a heart (IRR, 1.40; 95% CI, 1.05-1.88) transplant were associated with an increased risk of VPI occurrence.
In this study, 11.9% of SOT recipients experienced VPIs, and the incidence rate was higher than in the general population. There was significant morbidity and mortality associated with these infections in the population that underwent SOT, which highlights the need for optimizing immunization strategies.
To assess the incidence rate of VPIs among SOT recipients and to evaluate whether SOT recipients are at increased risk for specific VPIs compared with the general population.
This nationwide cohort study used data from the Swiss Transplant Cohort Study on VPIs in individuals who underwent SOT from May 2008 to June 2019 (follow-up until December 2019) and data from the Swiss Federal Office of Public Health on notifiable VPIs in the general population in the same period. Data were analyzed from January 2021 to June 2022.
Solid organ transplant.
The main outcomes were the incidence rate of the following VPIs in SOT recipients: hepatitis A and B, diphtheria, Haemophilus influenzae infection, influenza, measles, mumps, pertussis, pneumococcal disease, poliomyelitis, meningococcal disease, rubella, tetanus, tick-borne encephalitis, and varicella zoster virus infection. Age-adjusted standardized incidence ratios were used to assess whether VPIs occurred more frequently in SOT recipients compared with the general population. For SOT recipients, factors associated with occurrence of VPIs were explored and the associated morbidity and mortality assessed.
Of 4967 SOT recipients enrolled (median age, 54 years [IQR, 42-62 years]; 3191 [64.2%] male), 593 (11.9%) experienced at least 1 VPI. The overall VPI incidence rate was higher in the population that underwent SOT (30.57 per 1000 person-years [PY]; 95% CI, 28.24-33.10 per 1000 PY) compared with the general population (0.71 per 1000 PY). The standardized age-adjusted incidence ratio for notifiable VPIs in SOT recipients was higher compared with the general population (27.84; 95% CI, 25.00-31.00). In SOT recipients, influenza and varicella zoster virus infection accounted for most VPI episodes (16.55 per 1000 PY [95% CI, 14.85-18.46 per 1000 PY] and 12.83 per 1000 PY [95% CI, 11.40-14.44 per 1000 PY], respectively). A total of 198 of 575 VPI episodes in the population that underwent SOT (34.4%) led to hospital admission, and the occurrence of a VPI was associated with an increased risk for death and/or graft loss (hazard ratio, 2.44; 95% CI, 1.50-3.99; P = .002). In multivariable analysis, age 65 years or older at the time of transplant (incidence rate ratio [IRR], 1.29; 95% CI, 1.02-1.62) and receipt of a lung (IRR, 1.77; 95% CI, 1.38-2.26) or a heart (IRR, 1.40; 95% CI, 1.05-1.88) transplant were associated with an increased risk of VPI occurrence.
In this study, 11.9% of SOT recipients experienced VPIs, and the incidence rate was higher than in the general population. There was significant morbidity and mortality associated with these infections in the population that underwent SOT, which highlights the need for optimizing immunization strategies.
Keywords
Humans, Male, Middle Aged, Aged, Female, Switzerland/epidemiology, Cohort Studies, Influenza, Human, Communicable Diseases/epidemiology, Vaccines, Organ Transplantation/adverse effects, Varicella Zoster Virus Infection/etiology
Pubmed
Web of science
Open Access
Yes
Create date
02/05/2023 15:22
Last modification date
01/03/2024 8:06
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