Background: Studies have shown that compliance with post-transplant vaccinations in children is low. Postulated reasons for such low vaccination rates include the lack of familiarity of the primary care physician (PCP) with post-transplant vaccination recommendations. The objective of this study was to determine the level of comfort and self-perceived knowledge of PCP's in our healthcare system on vaccinating patients who received either solid organ or bone marrow transplant.

Methodology: A survey of 90 PCP's employed under the Pediatric Institute at the Cleveland Clinic was performed December 2014. It consisted of 14 questions targeting demographics and professional experience of responders (6 questions) and attitudes on post –transplant vaccination (8 questions). The survey was generated and distributed using a web-based application (REDCap) . Results were described using quartiles for continuous variables and counts and percentages for categorical variables. Associations between survey questions were assessed using Kruskal-Wallis, Chi-square, and Fisher's exact tests, and Spearman rank correlation coefficients.

Results: 74 (82%) PCPs responded. Median time in practice was 18 years (range: 1-38 years); 69% had >1 transplant patients in their practice. Their self-perceived knowledge on vaccinations was “Fair” in 42% and “Good” or better in 54%. Main source of information came directly from the transplant center or from the American Academy of Pediatrics. 59% said they would feel very comfortable vaccinating patients if provided with guidelines by the transplant center. The majority of PCP's felt either not included (16%) or somewhat included (63%) in the transplant process. An overwhelming majority (81%) thought that the best place to vaccinate the patients was in their office rather than the transplant center. There was a significant association between increased comfort with vaccinating these patients and with preferring their office as the primary place for transplant patients to receive them.

Conclusions: Pediatricians are invaluable allies who can help improve vaccination compliance after organ transplantation. Establishing a strong communication network between the Transplant Center and PCP's, and providing them with information and guidelines, will help keep the PCP's engaged in the care of these medically complex patients.

CITATION INFORMATION: Gonzalez B, Worley S, Tang A, Saracusa C, Goldfarb J. Vaccination of the Pediatric Patient After Transplantation – Attitudes and Knowledge of the General Pediatrician. Am J Transplant. 2016;16 (suppl 3).

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