Improving Vaccination Rates for Influenza and Pneumococcal Disease in Pediatric Kidney Transplant Recipients
1Pediatric Kidney Transplant, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, 2Pediatric Kidney Transplant, Stanford University, Palo Alto, CA
Meeting: 2020 American Transplant Congress
Abstract number: B-058
Keywords: Kidney transplantation, Vaccination
Session Information
Session Name: Poster Session B: Kidney: Pediatrics
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Pediatric renal transplant recipients are highly vulnerable to infections caused by influenza and pneumococcus and vaccines are recommended in this population. At our center, several patients were hospitalized for influenza and one with pneumococcal sepsis who was unvaccinated for the PPSV23. Our team did not have any system in place to identify unvaccinated children or track immunization status. We designed a quality improvement (QI) project to increase vaccination rates for both influenza and PPSV23.
*Methods: At the start of the project in 2013, we conducted a retrospective chart review on all pediatric renal transplant recipients actively followed in our center to get a baseline vaccine rate. We formed a multi-disciplinary committee including administration, physicians, advanced practice providers, medical assistants and nurses to identify barriers to achieving immunizations (figure 1). The team then developed a process to provide both influenza and PPSV23 vaccines in the transplant clinic to pre and post-transplant patients and record vaccines in the medical record. Immunization rates were reassessed every year from 2013-2019 and the administration system was reevaluated yearly. The multidisciplinary group met monthly for the first 6 months and then yearly.
*Results: The total number of patients identified as actively followed in our clinic during the QI project ranged from 200-233. Initial vaccination rate was 9% for PPSV23 and 89% for influenza. After 1 year, the rate increased to 70% for PPSV23 and 94% for influenza and 5 years, 100% for PPSV23 and 99% for influenza (figure 2).
*Conclusions: Developing a method to track vaccination rates as well as reducing barriers by administering them in transplant clinic drastically increased the fraction of transplant patients who are protected against influenza and pneumococcal infections, thereby reducing risk of morbidity and mortality in this high-risk patient population. It proved to be readily implemented, successful, and sustainable. This model can be used in other transplant centers to increase vaccine rates.
To cite this abstract in AMA style:
McGrath AM, Baquir J, Maestretti L, James G, DiNello K, Patton M, Fong A, Gallo A, Sigurjonsdottir V, Grimm P, Chaudhuri A. Improving Vaccination Rates for Influenza and Pneumococcal Disease in Pediatric Kidney Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/improving-vaccination-rates-for-influenza-and-pneumococcal-disease-in-pediatric-kidney-transplant-recipients/. Accessed May 16, 2025.« Back to 2020 American Transplant Congress