Whereas transplantation increases risk for infectious diseases, vaccination is a critical preventative intervention that recommended to be completed before transplantation. Vaccine refusal in the transplant preparation phase is a recurring issue that raises ethical and practical issues around safely proceeding with a transplant. There are many potential reasons why some vaccines may be declined, and a systematic approach to identifying barriers to complete vaccination is needed by the clinician, in order to maximize protection of the vulnerable transplant recipient. This webinar will present two cases to illustrate some of these issues, and will convene a panel to respond to questions from the webinar participants on the topic.
Learning Objectives
Upon completion of the webinar, the participants will be able to:
identify potential contributors to vaccine hesitancy;
consider factors associated with the relative risk from declining particular vaccines in relation to a particular patient;
consider ethical issues that may result from a policy of strict vaccination requirement for all transplant candidates.
Chair, IPTA Ethics Committee
Director, Pediatric Transplant Program BC Children’s Hospital
Tom Blydt-Hansen, MDCM, FRCPC, is Associate Professor of Pediatrics at the University of British Columbia, Director of the Multi Organ Transplant Program at BC Children’s Hospital and Senior Scientist at the BC Children’s Hospital Research Institute. He is a past-President of the Canadian Society of Transplantation, Board member of the NAPRTCS Registry, and he is an IPTA Council Member and Ethics Committee Chair since 2021.
Clinical Professor, Director of Pediatric Infectious Diseases Program for Immunocompromised Hosts
Stanford University Medical Center
Hayley Gans is a Clinical Professor of Pediatrics at Stanford University Medical Center. She spends her clinical time on the Pediatric Infectious Diseases service, and Co-directs the Pediatric Infectious Diseases Program for Immunocompromised Hosts. The focus of Dr. Gans’ research has included investigations into the innate and adaptive immunity to viral vaccines in several different populations, including infants receiving an early measles vaccination regimen which then expanded to include preterm infants, HIV infected adults and children, and children and adults undergoing liver transplantation. Subsequent studies focused on adenovirus, CMV, poliovirus, varicella and mumps. Current studies include immune recovery following pediatric solid organ transplantation.
Professor of Pediatrics, Pediatric Infectious Diseases
University of Pittsburgh School of Medicine
UPMC Children’s Hospital of Pittsburgh
Dr. Marian Michaels has worked in pediatric infectious diseases for over 30 years with her research and clinical work largely revolving around immunocompromised hosts with an emphasis on those undergoing transplantation. Dr Michaels has been active with international transplant societies and those in the United and currently serves on the board of OPTN/UNOS. She has conducted studies on immunizations and vaccine efficacy and is passionate about prevention of infections in our vulnerable population.
Clinical Assistant Professor, Pediatric Critical Care Medicine and Pediatrics
Medical Lead Transplant ICU,
Stanford University
Mihaela Damian, MD, MPH, is a Clinical Assistant Professor of Pediatrics and Pediatric Critical Care Medicine at Stanford University, the Medical Lead of Transplant ICU at Stanford Children’s Hospital Ca, USA. Dr. Damian is member of the IPTA Ethics and Allied and Health Professionals committee. At Stanford, Dr Damian leads clinical research and quality improvement efforts for all the solid organ transplantation, continuous renal replacement therapy programs in PICU.
Section Head, Pediatric Nephrology Max Rady College of Medicine
Aviva Goldberg is Section Head of Nephrology in the Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba. She completed a clinical fellowship in Bioethics and Medical Humanities at Northwestern University and holds a Masters of Arts in Bioethics and Health Policy from Loyola University Chicago. Dr. Goldberg is Secretary of the Canadian Society of Transplantation and Associate Dean, UGME Student Affairs at the Max Rady College of Medicine. She is one of the academic leads for the Canadian Donation and Transplantation Program theme 5- Improving the Culture of Donation in Canada.
Staff Physician, Pediatric Infectious Diseases Unit Geneva University Hospitals and Faculty of Medicine
After completing his Medical School and Pediatrics residency at the University Hospitals of Geneva and Faculty of Medicine, Switzerland, Dr L’Huillier’s interest in transplant infectious diseases and clinical virology motivated a 2-years fellowship in Pediatric Infectious Diseases at the Hospital for Sick Children, Toronto (Canada) where he gained clinical and research experience in the field. He then completed another 2-years research fellowship in Transplant Infectious Diseases at the University Health Network in Toronto, focusing on transplant virology. Since July 2019, he has been appointed as a Junior Faculty in Geneva University Hospitals’ Pediatric Infectious Diseases Unit where he continues to focus on clinical care and research projects in pediatric and adult transplant infectious diseases. He is also the pediatric representative of the Swiss National COVID-19 Science Task Force and the president of the ID care committee at IPTA.
Full Professor and Head of Clinical Unit Renal and Solid Organ Transplant
Red Cross War Memorial Children’s Hospital,
University of Cape Town
Immediate Past President IPTA
Full Professor & Head of Clinical Unit of Paediatric Nephrology and Solid Organ Transplantation at Red Cross War Memorial Children’s Hospital, Cape Town, as well as a Senior Lecturer at the University of Cape Town, South Africa. Mignon McCulloch is the Immediate Past-President of the International Paediatric Transplantation Society (IPTA) and Current President of the South African Paediatric Association (SAPA).
Her interests include Paediatric Transplantation in Cape Town (coordinating paediatric renal and liver transplant services and establishing cardiac and lung transplant services). She has also developed an Adolescent transition clinic for renal transplant patients.
Dr. McCulloch's other interests include Paediatric Nephrology and Care of Critically ill children specifically with AKI requiring all forms of dialysis in infants and children. This includes doing training Fellows and outreach work in various parts of Africa developing paediatric renal and transplant programs. She has previously worked in paediatric renal units in the UK including Great Ormond Street Children’s, Evelina London Children’s Guys and Kings’ Hospitals.
Carolyn and Matthew Bucksbaum Professor of Clinical Ethics and Pediatrics Associate Director, MacLean Center for Clinical Medical Ethics Professor, Departments of Pediatrics, Medicine Surgery and The College, University of Chicago, Chicago IL
Lainie Friedman Ross, MD, PhD, is the Carolyn and Matthew Bucksbaum Professor of Clinical Medical Ethics; Professor, Depts of Pediatrics, Medicine, Surgery and the College; Co-Director of the Institute for Translational Medicine, and Associate Director of the MacLean Center for Clinical Medical Ethics at the University of Chicago. She is a practicing pediatrician with research interest in the ethics of transplantation, pediatrics, genetics and human subjects protections. She has published 2 books on organ transplantation: Transplantation Ethics, 2nd edition (with Robert M Veatch, Georgetown University Press, 2016) and The Living Organ Donor as Patient: Theory and Practice (with Dick Thistlethwaite, Oxford University Press, 2021).