*Purpose: This study assesses the impact of including an Infectious Disease (ID) component in the pre-transplant evaluation on patients’ compliance with the CDC recommended vaccination schedule.

*Methods: We reviewed all patients 18 years old or younger who were evaluated for heart transplant between 1/1/2013 and 3/1/2018 from a single pediatric heart transplant center. The study period included dates before and after the implementation of an ID pre-transplant evaluation program in October 2015. Immunization data were abstracted from the electronic medical record and/or the state Immunization Registry. Vaccination status was characterized based on age, transplantation status, and pre-existing immunodeficiency. Vaccine compliance was recorded based on the routine CDC childhood vaccination schedule and vaccines indicated due to specific health conditions. The study was approved by the IRB.

*Results: The study included 49 subjects who were evaluated before involvement of ID in the evaluation process and 46 subjects who received formal ID evaluation. Among subjects who did not receive formal ID evaluation, full compliance with CDC recommended vaccinations increased by 6% within 3 months of their transplant evaluation. Subjects who received formal ID evaluation saw a 39% increase in full compliance and displayed a similar likelihood of being up-to-date with immunizations (OR = 2.05, 95% CI: 0.9, 4.66). In terms of uptake of vaccine recommendations, subjects without and with formal ID involvement received 21% and 48% of recommended vaccine doses, respectively, within 3 months of the pre-transplant evaluation. The addition of a formal ID evaluation increased compliance with the first dose of HPV vaccine from 64% to 100%. Compliance with vaccines recommended outside of the routine childhood schedule was 38% among subjects prior to ID involvement with no change at 3 months, and increased with ID evaluation from 29% to 57%.

*Conclusions: The addition of an ID evaluation to the pre-transplant evaluation process in pediatric heart transplant patients increased compliance with CDC vaccine recommendations. Increases were seen with overall compliance, number of recommended vaccine doses received, initiation of HPV vaccination, and vaccines not in the routine childhood schedule. We conclude that ID involvement in the pre-transplant evaluation is a valuable tool to improve vaccination status in this population.

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