Transplantation |

Influenza Vaccination Rates and Influenza A Virus Infection Rates of Lung Transplant Recipients in Three Consecutive Influenza Seasons FREE TO VIEW

Mace Matthew Schuurmans*, MD; Esther Perret, BA; Kathrina Zangger, BA; Annette Boehler, MD
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University Hospital Zurich, Zurich, Switzerland

Chest. 2012;142(4_MeetingAbstracts):1101A. doi:10.1378/chest.1390314
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SESSION TYPE: Lung Transplantation Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Influenza infection is considered a threat to lung transplant recipients (LTRs) because immunosuppression may lead to potentially severe viral infection and bacterial superinfection. Influenza vaccination is recommended for LTRs. For LTRs systematic assessments of influenza vaccination uptake and infection rates are rarely published. We aimed to assess influenza vaccination and influenza A infection rates during 3 influenza seasons.

METHODS: From 9/2009 until 4/2012 all LTRs followed up by our outpatient clinic were offered the influenza vaccine during the first months of the influenza season. Vaccination is voluntary. We evaluated LTRs for respiratory infections based on clinical suspicion and/or pathological laboratory results. We perform nasopharyngeal swabs (NPS) for microbiological and virological examination and treat patients with suspected influenza infection with moxifloxacin and oseltamivir pending NPS results. NPS are analyzed by real-time reverse transcriptase-polymerase chain reaction in order to detect influenza A virus and the H1N1 strain. In case of negative virological results we terminate oseltamivir treatment. Moxifloxacin is generally continued for 7 days. In laboratory proven influenza infection we continue oseltamivir and repeat NPS weekly. Descriptive statistics were based on the number of LTRs eligible for vaccination on December 31 of each year.

RESULTS: For the seasons 2009/10, 2010/11 and 2011/12 the results are given in the respective order: Vaccination rate (%): 88.1, 83.8 and 91.8. The number of infected LTRs with influenza A were (N): 7, 13 and 11, of which 5, 2 and 0 were non-vaccinated with the current vaccine. The infection incidence proportion (%) was 4.2, 7.5 and 6.0, respectively. The number of LTRs evaluated were 168, 173 and 183. The number of LTRs with laboratory documented prolonged viral shedding (> 7 days) for the last and current seasons were: 9 and 2. No influenza-related mortality was observed.

CONCLUSIONS: Vaccination rates were consistently higher than reported for other transplant cohorts. The infection incidence proportion showed minor variations in the last three years. The number of LTRs with prolonged viral shedding declined possibly due enhanced protection due to repeated vaccinations.

CLINICAL IMPLICATIONS: High rates of influenza vaccinations and early treatment may reduce frequency and severity of influenza infections among lung transplant recipients.

DISCLOSURE: The following authors have nothing to disclose: Mace Matthew Schuurmans, Esther Perret, Kathrina Zangger, Annette Boehler

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University Hospital Zurich, Zurich, Switzerland




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