Influenza is a significant cause of morbidity and mortality following lung transplant. We employ trivalent vaccination as per National Policy in our centre. The trivalent inactivated vaccine (TIV) is not protective against the 2017-18 circulating stain of Influenza B.
We reviewed the outcomes in 221 lung transplants recipients post vaccination.
All Patients are subject to influenza surveillance. Data include viral swabs, severity of symptoms, history of vaccination, immunosuppression and outcomes for lung transplant patients from November 2017 to date.
Ten patients have Influenza DNA detection of which 2 Influenza A and 8 Influenza B. The 10 cases had been vaccinated with the TIV vaccine. The cases presented in January 2018, were stratified as 1) mild, which were discharge home, or 2) severe, which required hospitalisation. All cases were treated with Oseltamivir (nebulised Zanamivir was added in the one of the Influenza B cases). Admission rates from Influenza B were 40%, and 1 patient admitted to intensive care unit died. All Influenza B cases were confirmed as B/Phuket/3073/2013-like (B/Yamagata lineage) virus. The costs for admission were €60,000 as per HSE reimbursement versus a total of €6000 Quadrivalent vaccination (QIV).
In our cohort, 80% were infected by Influenza B/Yamagata strain, poorly covered by TIV. Immunocompromised patients may benefit from QIV vaccination leading to a cost benefit by reducing hospitalization, morbidity and mortality.