100. Safety Analysis of Live-Attenuated Measles, Mumps, Rubella Vaccine Among Hematopoietic Cell Transplant Recipients Vaccinated Within Two Years of Transplant
Bibliographic record
Abstract
Abstract Background Measles, mumps and rubella (MMR) vaccine is a live-attenuated vaccine usually contraindicated within the first two years of hematopoietic cell transplant (HCT). During the 2019 measles outbreak at our center, the benefits of administering MMR vaccine within the first two years after HCT were weighed against the potential risks. Methods We conducted a retrospective review of patients who received MMR vaccination within two years of an autologous or allogeneic HCT. Patients’ demographics, date and type of HCT, underlying hematologic disease, type of immunosuppressive therapy and date of MMR vaccination were extracted from the electronic medical record. Adverse reactions that could be related to the vaccine were collected for up to 42 days post-vaccination and all hospitalizations and deaths following vaccination were reviewed. Results A total of 129 patients (75 autologous and 54 allogeneic HCT) were vaccinated between 300-729 days after HCT (median of 718 days). The median age at vaccination was 61 years old, 57% of the patients were male and 43% were on immunosuppressive therapy, 87% of whom were on maintenance therapy for multiple myeloma after auto-HCT. Seven patients (5%) had adverse reactions within 42 days of vaccination: six had respiratory tract infections (three with associated fever) and one had a rash leading to a brief hospitalization. This was a 37-year-old female who had an allogeneic HCT 542 days prior to MMR vaccination. She presented with a centrifugal maculopapular rash that was confirmed to be caused by the vaccine strain rubella virus (Fig 1). She fully recovered without sequalae. There was no other vaccine-associated illness identified in the cohort, after a median follow-up of 676 days. Conclusion MMR vaccine appears to be well tolerated in selected HCT recipients when given earlier than 2 years after transplant. No attributable severe outcomes or deaths were described. A mild uncomplicated case of vaccine-associated rubella illness was seen after vaccination. In the setting of a measles outbreak, assessment of potential risks and benefits of MMR vaccination given within two years of HCT remains important. Disclosures Stephen R. Walsh, MDCM, Janssen Vaccines (Scientific Research Study Investigator)Regeneron (Scientific Research Study Investigator)Sanofi Pasteur (Scientific Research Study Investigator) Matthew Cheng, MD, GEn1E Lifesciences (Advisor or Review Panel member)Kanvas Biosciences (Board Member, Shareholder)nplex biosciences (Advisor or Review Panel member) Sanjat Kanjilal, MD, MPH, GlaskoSmithKline (Advisor or Review Panel member) Nicolas C. Issa, MD, AiCuris (Scientific Research Study Investigator)Astellas (Scientific Research Study Investigator)GSK (Scientific Research Study Investigator)Merck (Scientific Research Study Investigator)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".