Immunizations

It is best for your child to be up-to-date on all immunizations prior to receiving his or her transplant. Once your child receives his or her transplant, they will not be able to receive ‘live’ vaccines and will have to wait at least six months post-transplant to be able to start receiving ‘inactive’ vaccines. Additionally, post-transplant your child’s immune system will be suppressed and will not respond as well to vaccinations.

Common Live Vaccines that Your Child Should Be Up-To-Date on Before Transplant:

• Chickenpox (varicella)

• Smallpox

• Oral polio

• Rotavirus

• Measles/mumps/rubella (MMR)

• BCG (for TB)

• Cholera

• Yellow fever

• Typhoid (oral)

• Influenza drops into the nose (influenza nasal mist, FluMist).

In general, your child should not have ‘live vaccines’ after transplant as they may cause disease in someone taking immunosuppressive medications.

If other people around your child have received live vaccines, this usually should not cause a problem. If your child is in a school or daycare in which other children or adults have received live vaccines, talk to the school or daycare providers about your child’s condition. For most situations, the live vaccine in other children or adults will not cause harm to your child. If you child has had an organ transplant, talk with your doctor about possible exposure to children who have received oral polio vaccine or smallpox vaccine or other live vaccines.

Some schools or activity programs may need a letter explaining why your child has not had live virus vaccines. Your family doctor or pediatrician or the transplant team can provide this letter.

When should you start immunizations after transplant?

It is very important that you keep up with the proper immunizations after transplant as your transplant team recommends, but you should not get them too early as your child’s immune system will be too suppressed and will not respond. Generally, waiting about 6 months after transplant before getting any immunizations is recommended, but your transplant team will advise you on how long to wait and which immunizations should be given.

Immunizations your Child Should Receive (depending on age) that are Killed (non-live)

Vaccines:

• Injectable polio

• Hepatitis A (HAV)

• Hepatitis B (HBV)

• Tetanus/diphtheria or Tetanus/diphtheria/acellular pertussis (Td or DTaP)

• Flu shot (influenza injectable)

• Pneumococcal (both Pneumovax or Prevnar)

• Meningococcal Vaccine (MCV4)

• HIB Vaccine

• HPV Vaccine (Gardasil, papillomavirus)

• TB skin test (which is actually not an immunization but a test to see if your child was exposed to tuberculosis [TB] before)

• Typhoid (injectable)

• Rabies

It is important to remember to avoid all live viral vaccines post-transplant and notify the transplant center when other vaccines are given. If you or your child’s primary physician has any questions or concerns about what immunizations can or should be given to your child, always contact your transplant center.