Determining Immunization Readiness Following Hematopoietic Cell Transplant

Abstract

Hematopoietic cell transplant (HCT) following treatment for pediatric cancer has allowed for survivors to live longer, fuller lives. Infections following transplant can be life threatening, and for some, preventable. Re-immunization for vaccine preventable diseases are a vital post-transplant follow-up and should be administered to the pediatric patient. Previously, the only recommendations to determine re-immunization readiness was time since transplant, with many providers using various variables to determine readiness on their own, without a center specific guideline.This project aimed to develop and implement a guideline to be utilized by hematology and oncology pediatric providers to determine re-immunization readiness following hematopoietic cell transplant in the pediatric patient. A presentation was made at a Hematology and Oncology pediatric provider meeting. This presentation reviewed the current literature and outlined a plan to create and implement a flowsheet guideline for determining readiness to initiate immunizations post-transplant. A survey was conducted to assess provider practice for determining immunization eligibility. A second survey was distributed pre- and post-guideline implementation in order to determine provider acceptance of the change and utilization of the practice guideline. A guideline was created, approved, and presented to the providers based on literature and current practice. This guideline may be used to assist Hematology and Oncology providers in determining immunization readiness following hematopoietic cell transplant. Utilization of the created guideline may prevent delays in re-immunization and ensure protection of pediatric post-HCT patients against vaccine-preventable diseases.