Addressing vaccination coverage among pediatric solid organ transplant candidates and recipients in the post-coronavirus disease 2019 pandemic period of increased vaccine hesitancy.

Document Type

Article

Publication Date

12-2025

Identifier

DOI: 10.1016/j.ajt.2025.08.007

Abstract

Pediatric solid organ transplant candidates and recipients remain undervaccinated and at higher risk of vaccine preventable illness (VPI) than the general population. An American Society of Transplantation Pediatric Community of Practice Controversies Conference was held in October 2023 to discuss opportunities to improve vaccine uptake and decrease rates of VPI in this population. Undervaccination results from failures at different levels. Clinician misconceptions about when vaccines may be contraindicated often lead to delays, and vaccines recommended by the Advisory Committee on Immunization Practices may not be readily available in subspecialty clinics involved in transplant care. Lack of linked electronic vaccine tracking and effective messaging also undermine vaccine administration efforts in this vulnerable population. While access and availability barriers along with provider knowledge gaps are important reasons for undervaccination in this population, vaccine hesitancy and refusal also can cause significant challenges. We suggest an individualized approach that prioritizes education and counseling about VPIs and vaccination in pediatric solid organ transplant candidates and recipients while still respecting parental autonomy within the clinician-patient-parent relationship.

Journal Title

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

Volume

25

Issue

12

First Page

2499

Last Page

2507

MeSH Keywords

Humans; COVID-19; Organ Transplantation; Vaccination Hesitancy; Child; Transplant Recipients; Vaccination Coverage; SARS-CoV-2; Vaccination; Pandemics; COVID-19 Vaccines

PubMed ID

40812615

Keywords

outbreak; pediatrics; solid organ transplantation; vaccine confidence; vaccine hesitancy; vaccine mandate; vaccine preventable illness

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