The suitable timing of Haemophilus influenzae type b vaccination after cardiac surgery: Vaccination after cardiac surgery

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Pediatrics International
Accepted Article

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The suitable timing of Haemophilus influenzae type b vaccination after cardiac surgery: Vaccination after cardiac surgery
Manabu Takanashi MD1, Shohei Ogata MD1,*, Takashi Honda MD1, Keiko Nomoto MS1, Eri Mineo MD1, Atsushi Kitagawa MD1, Hisashi Ando MD1, Sumito Kimura MD1, Yayoi Nakahata MD1, Norihiko Oka MD2, Kagami Miyaji MD3 andMasahiro Ishii MD1
DOI: 10.1111/ped.12899
Abstract
Background
The suitable timing of vaccination in infants with congenital heart disease (CHD) after cardiopulmonary bypass (CPB) surgery is unclear. However, it is important to prevent Haemophilus influenzae type b (Hib) infections in infants with CHD after CPB surgery. To reveal the suitable timing of Hib vaccination in infants with CHD after CPB surgery, we investigated the immunological status, and the efficacy and safety of Hib vaccination after CPB surgery.
Methods
Sixteen subjects who underwent surgical correction of a ventricular septal defect with CPB were investigated in this study. We evaluated the immunological status and cytokines were analyzed before surgery, 2 months after surgery, and before administering the Hib booster vaccination. The levels of Hib-specific IgG were also measured to evaluate the effectiveness of vaccination.
Results
All data regarding the immunological status before and 2 months after surgery, such as the population of whole blood cells and profile of lymphocyte subsets, were within the normal range and no subjects exhibited hypercytokinemia. Additionally, all subjects who received Hib vaccination at 2–3 months after CPB surgery had effective serum levels of Hib-specific IgG for protection against Hib infection without any side effects.
Conclusions
Our results show that CPB surgery does not influence acquired immunity and Hib vaccination may be immunologically safe to perform at 2 months after CPB surgery. The present study verified that Hib vaccination at 2–3 months after CPB surgery was effective in achieving immunization for infants with simple left to right shunt type CHD.