American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommendation for MMR vaccination after solid organ transplantation?

1. Recommended immediately

2. Contraindicated

3. Recommended annually

4. 6-12 months after transplantation

The correct answer is: Contraindicated

Following solid organ transplantation, there are specific recommendations regarding vaccinations, particularly live vaccines such as the measles, mumps, and rubella (MMR) vaccine. It is contraindicated to administer the MMR vaccine immediately after transplantation because transplant recipients are typically immunosuppressed due to medications and the need to prevent organ rejection. This immunosuppressed state can hinder an adequate immune response to the live attenuated virus present in the MMR vaccine, increasing the risk of complications from the vaccine itself. Recommendations generally state that live vaccines should be deferred until the patient has had time to recover their immune function. This usually means waiting until at least 6-12 months post-transplant, when the recipient could potentially mount a sufficient immune response to the vaccine. Hence, the approach to MMR vaccination after solid organ transplantation is one of caution, emphasizing the need to protect vulnerable patients from both infections and potential vaccine-related adverse effects.