Kidney Week

Abstract: SA-PO1134

Improving Vaccine Protection Among Adults Awaiting Kidney Transplant: A Multidisciplinary Quality Improvement Effort

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

• Kotzen, Elizabeth, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Elizabeth Kotzen, MD, MSc

• Arant, Elizabeth, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Elizabeth Arant, MD

• Lachiewicz, Anne, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Anne Lachiewicz, MD, MPH

• Dande, Gabriela, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Gabriela Dande, DO

• Moore, Katherine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Katherine Moore, FNP

• Parker, Lynley, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Lynley Parker, MD

• Detwiler, Randal K., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Randal K. Detwiler, MD

• Kleman, Mark A., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Mark A. Kleman, DO

• Baldwin, Brandy, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Brandy Baldwin

• Zink, Megan, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Megan Zink, RN

• Fuller, Eddie R., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Eddie R. Fuller, MD

• True, Karin A., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Karin A. True, MD, FASN

Background

We developed a single center multidisciplinary protocol for improving vaccination for prospective kidney transplant recipients (KTRs), using a patient-facing portable immunization worksheet designed to provide a framework for patient-clinician discussions during visits to primary care, dialysis, and the transplant center.

Methods

Patient education intervention: The patient-facing vaccine worksheet was provided to patients during pre-transplant nursing education sessions, and was reviewed as needed during physician visits.
Study inclusion: KTRs at UNC Health from January 2018 to December 2025 were included in this quality improvement initiative. Only the first transplant within the study period was considered in the analysis.
Analysis: We report proportion of KTRs who met the standard of care metric for each immunization during the baseline period (January 2018 to December 2019), and two intervention phases (January 2020 to December 2021; and January 2022 to December 2025).

Results

A total of 1,124 patients were included. Vaccination rates are depicted in figures 1 and 2.

Conclusion

During the study period, factors favorable for this effort included increased integration of the state immunization registry with the health system's electronic medical record; reduced complexity of the pneumococcal vaccination regimen; and improved insurance coverage for HPV vaccination in adults. Barriers to further implementation included vaccine hesitancy; fragmentation of care; and barriers to shifting the patient education tool from paper to electronic.