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RSV Vaccination in Stem-Cell Transplant Recipients
Hematopoietic stem-cell transplant (HSCT) recipients are at increased risk for severe disease following infection with respiratory syncytial virus (RSV). However, limited data are available on the immunogenicity, safety, and efficacy of RSV vaccines in this population. To address this gap, researchers evaluated 94 adult HSCT recipients who received the adjuvanted RSV vaccine at least 3 months posttransplant; 70% were more than 6 months posttransplant. The primary end point was seroresponse, defined as at least a fourfold rise in anti–RSV pre-F protein at 4 weeks postvaccination.
Key results were as follows:
- Seroresponse occurred in 32% of participants. Response levels increased with longer time since transplant.
- Cell-mediated immune (CMI) responses occurred in 37% of participants.
- The most common adverse event was injection-site pain.
- During a median 13 months of follow-up, RSV infection occurred in 9 participants, only 1 of whom had a humoral or CMI response to the vaccine. Two patients required intensive care unit admission.
Comment
Immune response to RSV vaccination is nearly universal in immunocompetent people. These data highlight the need for exploration of alternate vaccination strategies in HSCT recipients. However, they also demonstrate that the vaccines are safe and can generate an immune response in a modest yet substantial fraction of this vulnerable population. Thus, we should vaccinate HSCT recipients, preferably at the onset of the RSV season, and continue to recommend nonpharmacologic RSV-prevention measures such as masking, hand hygiene, and social distancing at the height of the season.
Citation(s)
Author:
Lötscher J et al.
Title:
Respiratory syncytial virus vaccination in adult allogeneic hematopoietic cell transplant recipients.
Source:
JAMA
2025
Oct
2; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
Hana M. El Sahly, M.D.