VACCINE PREVENTABLE DISEASE IN IMMUNOSUPPRESSED PEOPLE WITH KIDNEY DISEASE

A GRAVER¹, L COOLEY², S KUO¹, G KIRKLAND¹, M JOSE¹

¹Renal Unit, Royal Hobart Hospital, Tasmania; ²Department of Microbiology and Infectious Diseases, Royal Hobart Hospital, Tasmania

Aims: To assess the current vaccination status of Royal Hobart Hospital (RHH) patients immunosuppressed due to kidney disease, and to develop and implement a vaccination program based on Australian immunisation guidelines to reduce Vaccine Preventable Diseases (VPDs).

Background: People with kidney disease suffer frequent infections resulting in substantial morbidity and mortality. Several of these infections can be prevented with appropriate and timely vaccination, however the completeness of vaccination in our institution is unknown.

Methods: We conducted a retrospective review of vaccination records obtained from General Practitioners of immunosuppressed RHH patients with kidney disease, and compared this to the recommendations of the Australian Immunisation Handbook (AIH), 10^th Edition (2017 update). We then developed a vaccination program according to these guidelines and will prospectively review all infections in the first 24 months following completion of the program.

Results: To date, 140 patients have been identified, including 124 with renal transplants and 16 active on the waiting list. Vaccination records were obtained for 90 patients (64% return rate; 41 females, mean age 57). No patients had complete vaccination records as per AIH. 37/90 (41.1%) had received an annual influenza vaccination for the preceding 3 years, and despite 16/90 (17.8%) receiving 2 separate Pneumococcal vaccinations (23-valent) within 10 years, none were correctly vaccinated as per AIH recommendations. 19/90 (21.1%) received a Pertussis booster within 10 years, whilst 2/90 (2.2%) received a Varicella Zoster Virus vaccine (Varilrix – 1, Zostavax – 1).

Conclusions: Adherence to Australian Immunisation Guidelines was poor prior to the development of the vaccination program. We have developed and implemented a comprehensive vaccination program with the aim of reducing VPDs in a cohort of immunosuppressed patients with kidney disease.