Background: In solid organ transplant (SOT) recipients, influenza infection can lead to subsequent graft dysfunction and mortality. In an effort to increase vaccination rates, transplant pharmacy began screening SOT patients and providing recommendations regarding influenza vaccinations during the 2014 influenza season. The purpose of this study was to evaluate the impact of pharmacy-initiated interventions on the rate of influenza vaccination (and thereby the impact on diagnosis of influenza) in pediatric SOT recipients.

Methods: This was a retrospective review of kidney, liver, and heart transplant recipients from September 1, 2011 through February 16, 2017 who were actively followed at our center. Influenza vaccination rates and diagnosis were assessed pre-implementation (2011-2013) and post-implementation (2014-2016) of the vaccination program by pharmacy in SOT patients.

Results: A total of 822 patients were included, and 101 (12.7%) were diagnosed with influenza while 40 (5%) were hospitalized secondarily to influenza during the study period. Vaccination rates increased over time with 144 (36.3%) patients vaccinated in 2011 compared to 430 (73.5%) in 2016 (p<0.001). Influenza diagnosis rates decreased when comparing the pre- and post-implementation eras from 52 to 49 diagnoses (p=0.006). No significant difference was found comparing the pre- and post-intervention eras correlating the vaccination and subsequent hospitalization; however, hospitalizations did decrease from 21 in the pre-intervention era to 19 in the post-intervention era (p=0.613). The median time in which 50% of the population was vaccinated decreased over time from 163 days in 2012 to 94 days in 2016 (p<0.001). Of those diagnosed with influenza, 41% were unvaccinated.

Conclusion: Influenza vaccination rates significantly increased with transplant pharmacy vaccination implementation, and as a result, diagnosis of influenza decreased between pre- and post-implementation eras. Time to vaccination decreased over the six year period; however, many patients diagnosed with influenza were unvaccinated or vaccinated after influenza diagnosis. As a result, earlier influenza vaccination in SOT patients is recommended.

CITATION INFORMATION: Gattis S., Yildirim I., Serluco S., McCracken C., Liverman R. Impact of Influenza Vaccine Implementation by Transplant Pharmacy in Solid Organ Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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