The recommendations in this table are built on the principle that, where possible, children and adults should complete an age-appropriate vaccination schedule for all vaccines before transplantation. If this has not occurred, the person should receive additional vaccine doses before transplantation, if possible. Some additional vaccine doses are also recommended after transplantation (see ‘Comments’ column).

Vaccine

Before transplantation

After transplantation, (if full vaccine course not given beforehand)

Comments

DTPa (diphtheria-tetanus-pertussis)–containing vaccine for children <10 years of age and dTpa for those ≥10 years of age

Yes

Yes

  • Recipients <10 years of age and not previously vaccinated should receive at least 3 primary doses as DTPa-containing vaccine, and then follow the routine schedule for their age.
  • Recipients ≥10 years of age and not previously vaccinated should receive the 1st dose as dTpa, followed by 2 doses of dT. If dT is unavailable, complete vaccination course with dTpa.
  • Adults who have received at least 3 primary doses of a diphtheria-tetanus-pertussis–containing vaccine should receive a dose of dTpa after transplant if their last dose was more than 10 years ago.
  • See also Catch-up vaccination

Hib (Haemophilus influenzae type b) vaccine

Yes (for children); not indicated for adults

Yes (for children); not indicated for adults

  • If possible, complete vaccination before transplantation.

Hepatitis A vaccine

Yes, if seronegative (see comments)

Yes, if seronegative (see comments)

Recommended for:

  • all liver solid organ transplant recipients
  • transplant candidates or recipients with chronic liver disease
  • those chronically infected with either hepatitis B or hepatitis C

Hepatitis B vaccine

Yes, if seronegative (see comments)

Yes, if seronegative (see comments)

9vHPV (9-valent human papillomavirus vaccine

Yes

Yes

  • 2-dose schedule (0, 6–12 months) is recommended for people who are immunocompetent and start vaccination before their 15th birthday.
  • 3-dose schedule (0, 2, 6 months) is recommended for people who are immunocompetent and start vaccination after their 15th birthday.
  • If a person has a solid organ transplant before completing the course, a 3-dose schedule is recommended.
  • 3-dose schedule (0,  2,  6 months) of 9vHPV is recommended for people who are vaccinated after transplant.
  • For people >19 years of age, conduct a risk assessment to determine their need for vaccination.
  • For more details, see Human papillomavirus.

IPV (inactivated poliovirus) vaccine

Yes

Yes

  • Adults who have received a routine course of polio vaccination in childhood are recommended to receive a booster every 10 years if they plan to travel to a polio-endemic area or have an occupational risk of polio exposure (eg laboratory workers).

Influenza vaccine

Yes (1  dose every year for people ≥6  months of age)

Yes (2  doses in 1st  year after transplant, then 1 dose every year after that)

  • 2  doses in 1st  year after transplant should be given 4 weeks apart.
  • Children aged 6  months to <9 years are recommended to receive 2 doses before transplant if they are receiving influenza vaccine for the 1st  time.

MenB (meningococcal  B) vaccine

Yes, if at risk due to age or other defined risk factors (see comments)

Yes, if at risk due to age or other defined risk factors (see comments)

MenACWY (quadrivalent meningococcal conjugate) vaccine

Yes

Yes

MMR (measles-mumps-rubella) vaccine

Yes (at least 1 month before transplantation, if possible)

Contraindicated

  • Confirm immunity by serological testing before transplantation.
  • If seronegative, complete a 2-dose primary vaccination schedule for children and adults before transplantation, provided the person is not immunocompromised at that time.

13vPCV (13-valent pneumococcal conjugate vaccine)

Yes

Yes

23vPPV (23-valent pneumococcal polysaccharide vaccine)

Yes (≥8 weeks after 13vPCV)

Yes (≥8 weeks after 13vPCV)

Varicella vaccine

Yes, (at least 1 month before transplantation, if possible)

Contraindicated

  • Confirm immunity by serological testing before transplantation.
  • If seronegative, complete a 2-dose primary vaccination schedule for children and adults before transplantation, provided the person is not immunocompromised at that time.

Source: Danzinger-Isakov et al,22 Centers for Disease Control and Prevention23

Last updated: 
5 June 2018
Last reviewed: 
5 June 2018

Definitions

DTPa
diphtheria-tetanus-acellular pertussis vaccine
dTpa
diphtheria-tetanus-acellular pertussis vaccine, reduced antigen content formulation
dT
diphtheria-tetanus vaccine for use in adults
IPV
inactivated poliomyelitis vaccine
MMR
measles-mumps-rubella
13vPCV
13-valent pneumococcal conjugate vaccine
23vPPV
23-valent pneumococcal polysaccharide vaccine