Abstract: SA-PO1133
Real-World Effectiveness of the Recombinant Zoster Vaccine in Kidney Transplant Candidates
Session Information
- Transplantation: Clinical - Infectious Diseases
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Sandhu, Sharneet K., Massachusetts General Hospital, Boston, Massachusetts, United States
- Al Jurdi, Ayman, Massachusetts General Hospital, Boston, Massachusetts, United States
Background
Herpes zoster (HZ) is a common infection in kidney transplant (KT) recipients and can result in serious complications. The clinical effectiveness of pre-transplant recombinant zoster vaccine (RZV) in KT recipients (KTRs) and candidates has not been studied.
Methods
To estimate the average effect of pre-transplant RZV in KT candidates on post-transplant HZ in a real-world setting, we conducted an observational, two-center, retrospective cohort study of all KT candidates aged >50 years who received their first KT between 1/1/2018 and 12/31/2024. The exposure of interest was the receipt of two RZV doses pre-transplant. The primary outcome was the time to first HZ event post-transplant. Propensity scores for receiving RZV were estimated then ATE inverse probability of treatment-weighted cumulative incidence functions, accounting for death as a competing risk, were used to estimate the cumulative incidence of HZ.
Results
The cohort included 448 KTRs (218 vaccinated and 230 unvaccinated). After weighting, baseline covariates were well balanced between the two groups. The 5-year cumulative incidence of post-transplant HZ was 3.8% in the vaccinated group and 10.4% in the unvaccinated group. This corresponded to an absolute risk difference of −6.6% (95% CI, −13.2% to −0.001%, P=0.049). The effectiveness of pre-transplant RZV waned over time.
Conclusion
Pre-transplant RZV in KTRs resulted in a lower post-transplant cumulative incidence of HZ in a real-world setting. Waning effectiveness suggests KTRs may benefit from post-transplant booster doses.
Figure. Effect of pre-transplant vaccination on post-transplant zoster in kidney transplant recipients.(Top panel) Cumulative incidence of post-transplant herpes zoster, stratified by pre-transplantrecombinant zoster vaccination (RZV). (Bottom panel) Time-varying hazard ratio for RZV on post-transplant zoster.