Immunizations for pediatric transplant patients.

Infection remains a major cause of morbidity and mortality in transplant patients. Many infections, however, can be successfully prevented by immunization. This presentation reviews the problems associated with, and the questions that arise concerning the use of routine pediatric vaccines, such as diphtheria-pertussis-tetanus (DPT) and measles-mumps-rubella (MMR). It also reviews the use of special vaccines such as hepatitis B, pneumococcal, and influenza vaccines in transplant patients. Data concerning the use of two experimental, live-attenuated virus vaccines, against cytomegalovirus (CMV) and varicella, are discussed. The live-attenuated varicella vaccine can be predicted to decrease the morbidity and mortality of varicella-zoster virus infection in transplant patients. It has already been given successfully to immunocompromised children and is highly effective in the prevention of varicella.