*Purpose: There are many potential infections post-transplant, with influenza as the most common vaccine-preventable infection the first 5 years post-transplant. Despite effective vaccines, uptake is low in high-risk transplant patients who are recommended to receive pneumococcal and annual influenza vaccines among others. While disparities in vaccination have been observed by race, with lower uptake among Blacks and Hispanics, little is known about the role socioeconomic status including education, marital status and geographic location play in vaccine uptake. To improve health outcomes and vaccine coverage, we must first know where gaps exist.

*Methods: We conducted a cross-sectional, population-based study using the Rochester Epidemiology Project (REP), a medical records linkage system, to assess influenza and pneumococcal vaccination among adults aged 19-64 years old with solid organ transplants, living in four counties in southeastern Minnesota. Vaccination data was obtained from the Minnesota Immunization Information Connection (MIIC) from June 1, 2010-June 30, 2020.

*Results: 468 solid organ transplant patients were identified. A majority was White (83%), married (58%) and living in an urban setting (81%) with a college education or beyond (39.2%). The most common transplant was kidney transplant (70%). Liver and lung transplant patients were least vaccinated for flu, while heart transplants were least up to date on pneumococcus. Asians had the highest vaccine uptake rate while mixed race had the lowest. Higher education correlated with higher vaccination rates. Those living in urban settings were better vaccinated than suburban or rural settings. Influenza vaccination was slightly higher than national averages, ranging from 47-53% over the past 10 years, while a cohort in the same area of adults deemed high-risk adults for pneumococcus had significantly lower influenza vaccination ranging from 34-42%.

*Conclusions: Rates of vaccination were well below national goals, even though transplant recipients did better than other high-risk groups. Part of the transplant process includes rigorous review of vaccinations with close follow-up. The disparities observed by education, race, and geographic region do not fully explain the vaccination failure in this population at high risk for morbidity and mortality from infection. Further investigation is needed to understand and address barriers to vaccination, especially among certain subsets.

« Back to 2022 American Transplant Congress