469: High Rate of Revaccination in Allogeneic and Early Autologous Stem Cell Transplantation — Results of a Single Center Compliance Tracking Survey

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Background: Hematopoietic stem cell transplants (HSCT) have increased over the past 25 years. With improving HSCT outcomes, the number of long-term survivors has grown. HSCT recipients lose their memory immune response against common vaccine-preventable infections and suffer from life-threatening late infectious complications. Revaccination is an important strategy for reducing the risk of preventable infections after HSCT. Materials and Methods: After the implementation of an annual post transplant clinic, compliance with revaccination recommendations of the Infectious Disease Working Party of the EBMT (BMT 2005) was analyzed. Initially letters were sent to patients greater than 1 year post transplant inviting them to visit the clinic. The goal of the annual clinic was to educate HSCT recipients, identify complications, and recommend therapy for long-term post-transplant issues. Patients were encouraged to bring their immunization records to their appointments. Data were collected from January 2006 until August 2007 utilizing patient histories and computer data base documentation tools for the clinic. Schedules were generated based on the recommendations of the Infectious Diseases Working Party of the EBMT. Results: 42 subjects, 27 autologous and 15 allogeneic, attended annual clinic during this time period. 27 patients had initiated the recommended vaccination schedule and/or elected to start or continue the re-immunization schedule after attending the clinic. Fifteen patients declined vaccinations (11 autos and 4 allos) for various reasons including time out from transplant (median 10 years), 1 completed recommended series, 1 due to immunosuppressive therapy, and 1 with history of adverse reaction to vaccine excipients. Patients declining full revaccination were encouraged to maintain standard revaccinations such as yearly influenza shots and ten year diphtheria/tetanus boosters. There were no toxicities associated with revaccination. Conclusion: Education and implementation of post HSCT revaccination was well received by patients. A high proportion of allogeneic and early autologous HSCT recipients successfully underwent revaccination.