Table. Recommended vaccines for people before and after a solid organ transplant

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)	Recommended for all seronegative solid organ transplant candidates. Immunogenicity is likely to be improved when candidates receive the vaccine before transplantation. Can use an accelerated schedule before transplantation— see Table. Accelerated hepatitis B vaccination schedules for people with imminent risk of exposure.
9vHPV (9-valent human papillomavirus vaccine	Yes	Yes	1 dose is recommended for people who are immunocompetent and start vaccination before their 26th birthday. 3-dose schedule (0, 2, 6 months) is recommended for people who are immunocompetent and start vaccination after their 26th 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 >25 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)	MenB vaccine is recommended for certain age groups and individuals with specific risk factors placing them at increased risk of invasive meningococcal disease (see Meningococcal disease). The number of doses varies with age. See Table. Recommendations for MenB vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease in Meningococcal disease.
MenACWY (quadrivalent meningococcal conjugate) vaccine	Yes	Yes	MenACWY is recommended for certain age groups and individuals with specific risk factors placing them at increased risk of invasive meningococcal disease (see Meningococcal disease). The number of doses varies with age. See Table. Recommendations for MenACWY vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease in Meningococcal disease.
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.
PCV (pneumococcal conjugate vaccine) - 13vPCV, 15vPCV [if ≥18 years of age] or 20vPCV [if ≥18 years of age]	Yes	Yes	1 dose (in addition to those routinely offered in childhood). See Pneumococcal disease and Table. Catch-up schedule for 13vPCV for Aboriginal and Torres Strait Islander children living in NT, Qld, SA or WA ONLY, and all children with risk condition(s) for pneumococcal disease, aged <5 years.
23vPPV (23-valent pneumococcal polysaccharide vaccine)	Yes (2–12 months after a dose of PCV (pneumococcal conjugate vaccine [13vPCV, 15vPCV or 20vPCV]))	Yes (2–12 months after a dose of PCV (13vPCV, 15vPCV or 20vPCV)	2 doses at least 5 years apart. See Pneumococcal disease and Table. Catch-up schedule for 13vPCV for Aboriginal and Torres Strait Islander children living in NT, Qld, SA or WA ONLY, and all children with risk condition(s) for pneumococcal disease, aged <5 years.
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.
Recombinant zoster vaccine (Shingrix)	Yes (complete 2-dose schedule at least 1 month before transplantation, if possible)	Yes	2 doses 2-6 months apart prior to transplantation. 2 doses 1-2 months apart following transplantation. Shingrix is registered for people aged ≥18 years who are immunocompromised.
Source: Danzinger-Isakov et al,²² Centers for Disease Control and Prevention²³

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Last updated

11 May 2023

Last reviewed

11 May 2023

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Table. Recommended vaccines for people before and after a solid organ transplant

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