IMMUNIZATION PRACTICES IN CHILDREN WITH RENAL-DISEASE - A REPORT OF THE NORTH-AMERICAN PEDIATRIC RENAL-TRANSPLANT COOPERATIVE STUDY

To determine the current immunization recommendations of practicing pe diatric nephrologists, a questionnaire was sent to the members of the North American Pediatric Renal Transplant Cooperative Society. Sixty-t wo percent of the centers responded. The results of the survey suggest that although consensus for approaching immunization does exist, reco mmendations do vary from center to center. Virtually all centers recom mend standard vaccines [DTP, oral poliovirus (OPV), hepatitis B (Hep B ), and Haemophilus influenzae B (Hib)] for their renal insufficiency a nd dialysis patients. Despite the fact that they are not infectious, s tandard killed vaccines (DTP, Hep B, Hib) are recommended less frequen tly for transplanted patients (86%) than their renal insufficiency (98 %) and dialysis (near 100%) counterparts. Additionally, OPV and measle s/mumps/rubella (MMR), both live viral vaccines, are rarely recommende d post transplant. Almost 90% of centers recommend the use of influenz a vaccine, while only 60% of centers recommend pneumococcal vaccine fo r children with renal disease. Over 70% of centers recommend the newly licenced varicella vaccine for patients on dialysis and those with re nal insufficiency. Between 5% and 12% of centers recommend live viral vaccines, including OPV, MMR, and varicella vaccine, for immunosuppres sed patients post renal transplant.