Vaccination and Safe Living Strategies for Solid Organ Transplant Candidates and Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

These updated guidelines of the AST IDCOP review safe living practices including routine vaccinations, travel vaccinations including general travel advice, as well as non-pharmacological strategies for safe living. General principles of vaccination as well as the use of specific vaccines in this population are discussed. Vaccination status should be reviewed and updated in the pre-transplant setting and when travel is planned. The optimal timing of vaccination post-transplant should be taken into account. There are accumulating data that live-attenuated vaccines can also be given to select post-transplant pediatric and young adult patients. Since the last update of the guidelines in 2019, several new vaccines are recommended such as those for COVID-19 and RSV. In addition, newer formulations of pneumococcal, meningococcal, and hepatitis B vaccinations are available. There are expanded age indications for recombinant zoster vaccine. Close contacts of transplant patients can receive most routine live and inactivated vaccines. For travel, location, duration, and activity during the trip determines the vaccine requirements as well as the need for malaria chemoprophylaxis. Other strategies for safe living include considerations for food, water, pets, and sexual activity. Detailed recommendations surrounding these are included in these guidelines.