{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:08:22Z","timestamp":1790672902892,"version":"4.1.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vaccine-preventable infections are a major cause of morbidity and mortality among kidney transplant recipients, yet real-world adherence to recommended vaccination schedules remains poorly characterised. We aimed to assess adherence to the full vaccination schedule and identify its independent predictors in a large Italian cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single-centre retrospective cohort study of consecutive adult kidney transplant recipients at the University Hospital of Padua (Veneto, Italy), 2013\u20132024. Adherence was assessed on the regional immunisation registry data and quantified using a composite vaccination adherence score encompassing up to ten vaccines according to patient-specific elegibility ranging from 0 (adherent to no vaccination) to 1 (adherent to all vaccinations). Determinants were analysed by fractional logit regression (quasi-binomial GLM, logit link, HC1 robust standard errors); sensitivity analyses excluded influential observations by Cook\u2019s distance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 784 recipients (mean age 52.9\u2009\u00b1\u200912.3 years; 63.7% male), median adherence score was 0.25 (IQR 0.13\u20130.44) and only 11 patients (1.4%) were fully adherent. Per-vaccine adherence was highest for COVID-19 (87.4%) and HBV (61.9%), and lowest for Hib (7.9%), MenB (9.0%), HPV (13.1%), and RZV (13.8%). In the multivariable model, transplant in 2023\u20132024 (aOR 1.53, 95%CI 1.25\u20131.89;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and older age (aOR 1.01\/year, 95%CI 1.00\u20131.02;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030) were independently associated with higher adherence, whereas unknown underlying renal pathology (aOR 0.77, 95% CI 0.62\u20130.96;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and re-transplantation (aOR 0.73, 95%CI 0.56\u20130.95;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) predicted lower adherence. Findings were robust in sensitivity analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vaccination adherence was suboptimal, with patients with unknown renal pathology representing a particularly vulnerable subgroup. Temporal improvement closely aligned with regional guideline publication suggests that structured guideline implementation can meaningfully improve adherence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02969-7","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:41:20Z","timestamp":1790671280000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring vaccination adherence and its determinants in kidney transplant recipients: insights from a large italian transplant centre"],"prefix":"10.1007","author":[{"given":"Annamaria","family":"Cattelan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5276-2603","authenticated-orcid":false,"given":"Francesco Vladimiro","family":"Segala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Bragato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lolita","family":"Sasset","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Colombo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucrezia","family":"Calandrino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Katiana","family":"Martino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Cocchio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Di Bello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Di Bella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Nalesso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucrezia","family":"Furian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"2969_CR1","doi-asserted-by":"publisher","first-page":"2601","DOI":"10.1056\/NEJMra064928","volume":"357","author":"JA Fishman","year":"2007","unstructured":"Fishman JA. Infection in solid-organ transplant recipients. N Engl J Med. 2007;357:2601\u201314. https:\/\/doi.org\/10.1056\/NEJMra064928.","journal-title":"N Engl J Med"},{"key":"2969_CR2","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.3390\/vaccines11101611","volume":"11","author":"M Vigan\u00f2","year":"2023","unstructured":"Vigan\u00f2 M, Beretta M, Lepore M, Abete R, Benatti SV, Grassini MV, et al. Vaccination recommendations in solid organ transplant adult candidates and recipients. Vaccines. Multidisciplinary Digit Publishing Inst. 2023;11:1611. https:\/\/doi.org\/10.3390\/vaccines11101611.","journal-title":"Multidisciplinary Digit Publishing Inst"},{"key":"2969_CR3","doi-asserted-by":"publisher","first-page":"e56974","DOI":"10.1371\/journal.pone.0056974","volume":"8","author":"I Eckerle","year":"2013","unstructured":"Eckerle I, Rosenberger KD, Zwahlen M, Junghanss T. Serologic vaccination response after solid organ transplantation: a systematic review. PLoS ONE. 2013;8:e56974. https:\/\/doi.org\/10.1371\/journal.pone.0056974.","journal-title":"PLoS ONE"},{"key":"2969_CR4","doi-asserted-by":"publisher","first-page":"e44","DOI":"10.1093\/cid\/cit684","volume":"58","author":"LG Rubin","year":"2014","unstructured":"Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58:e44\u2013100. https:\/\/doi.org\/10.1093\/cid\/cit684.","journal-title":"Clin Infect Dis"},{"key":"2969_CR5","unstructured":"Regione Piemonte. Pazienti, Adulti candidati\/portatori di trapianto renale da donatore deceduto e. Vivente: Protocollo vaccinale [Internet]. 2018. https:\/\/www.seremi.it\/sites\/default\/files\/protocollo%20vaccinale%20pazienti%20candidati_portatori%20trapianto%20renale_definitivo_maggio2018.pdf"},{"key":"2969_CR6","unstructured":"Regione del Veneto. Offerta vaccinale per condizione di rischio [Internet]. 2023 [cited 2026 Mar 30]. https:\/\/bur.regione.veneto.it\/BurvServices\/Pubblica\/Download.aspx?name=Dgr_990_23_AllegatoD_510195.pdf&type=9&storico=False. Accessed 30 Mar 2026."},{"key":"2969_CR7","doi-asserted-by":"publisher","first-page":"2266932","DOI":"10.1080\/21645515.2023.2266932","volume":"19","author":"P Stefanizzi","year":"2023","unstructured":"Stefanizzi P, Bianchi FP, Moscara L, Martinelli A, Di Lorenzo A, Gesualdo L, et al. Determinants of adherence to influenza and COVID-19 vaccination in a cohort of solid organ transplant patients in Puglia, Southern Italy (2017\u20132022). Hum Vaccin Immunother. 2023;19:2266932. https:\/\/doi.org\/10.1080\/21645515.2023.2266932.","journal-title":"Hum Vaccin Immunother"},{"key":"2969_CR8","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1080\/21645515.2017.1264792","volume":"13","author":"V Restivo","year":"2017","unstructured":"Restivo V, Vizzini G, Mularoni A, Di Benedetto C, Gio\u00e8 SM, Vitale F. Determinants of influenza vaccination among solid organ transplant recipients attending Sicilian reference center. Hum Vaccin Immunother. 2017;13:346\u201350. https:\/\/doi.org\/10.1080\/21645515.2017.1264792.","journal-title":"Hum Vaccin Immunother"},{"key":"2969_CR9","doi-asserted-by":"publisher","first-page":"e12831","DOI":"10.1111\/tid.12831","volume":"20","author":"LF Camargo","year":"2018","unstructured":"Camargo LF, Lother AM, Mazzali M, Stucchi RSB. Immunization in end stage renal disease: The perception of waiting list patients. Transpl Infect Dis. 2018;20:e12831. https:\/\/doi.org\/10.1111\/tid.12831.","journal-title":"Transpl Infect Dis"},{"key":"2969_CR10","doi-asserted-by":"publisher","first-page":"6681","DOI":"10.1016\/j.vaccine.2016.11.015","volume":"34","author":"M Doherty","year":"2016","unstructured":"Doherty M, Schmidt-Ott R, Santos JI, Stanberry LR, Hofstetter AM, Rosenthal SL, et al. Vaccination of special populations: Protecting the vulnerable. Vaccine. 2016;34:6681\u201390. https:\/\/doi.org\/10.1016\/j.vaccine.2016.11.015.","journal-title":"Vaccine"},{"key":"2969_CR11","doi-asserted-by":"publisher","first-page":"16911","DOI":"10.1038\/s41598-025-01491-4","volume":"15","author":"Y Remane","year":"2025","unstructured":"Remane Y, Klaus VC, Heinitz K, Ranft D, Kowald J, Herber A, et al. Assessment of vaccination rates and motivation among transplant patients using vaccination cards and interviews. Sci Rep. 2025;15:16911. https:\/\/doi.org\/10.1038\/s41598-025-01491-4.","journal-title":"Sci Rep"},{"key":"2969_CR12","doi-asserted-by":"publisher","first-page":"e13537","DOI":"10.1111\/tid.13537","volume":"23","author":"L Larsen","year":"2021","unstructured":"Larsen L, Bistrup C, S\u00f8rensen SS, Boesby L, Nguyen MTT, Johansen IS. The coverage of influenza and pneumococcal vaccination among kidney transplant recipients and waiting list patients: A cross-sectional survey in Denmark. Transpl Infect Dis. 2021;23:e13537. https:\/\/doi.org\/10.1111\/tid.13537.","journal-title":"Transpl Infect Dis"},{"key":"2969_CR13","doi-asserted-by":"publisher","first-page":"e14010","DOI":"10.1111\/tid.14010","volume":"25","author":"JR Felzer","year":"2023","unstructured":"Felzer JR, Finney Rutten LJ, Wi C-I, LeMahieu AM, Beam E, Juhn YJ, et al. Disparities in vaccination rates in solid organ transplant patients. Transpl Infect Dis. 2023;25:e14010. https:\/\/doi.org\/10.1111\/tid.14010.","journal-title":"Transpl Infect Dis"},{"key":"2969_CR14","doi-asserted-by":"publisher","first-page":"e13749","DOI":"10.1111\/tid.13749","volume":"24","author":"D Tharmaraj","year":"2022","unstructured":"Tharmaraj D, Dendle C, Polkinghorne KR, Mulley WR. Kidney transplant recipients\u2019 attitudes toward COVID-19 vaccination and barriers and enablers to vaccine acceptance. Transpl Infect Dis. 2022;24:e13749. https:\/\/doi.org\/10.1111\/tid.13749.","journal-title":"Transpl Infect Dis"},{"key":"2969_CR15","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1681\/ASN.2021010104","volume":"32","author":"P Garcia","year":"2021","unstructured":"Garcia P, Montez-Rath ME, Moore H, Flotte J, Fults C, Block MS, et al. SARS-CoV-2 Vaccine Acceptability in Patients on Hemodialysis: A Nationwide Survey. 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Vaccine. 2023;41:6637\u201344. https:\/\/doi.org\/10.1016\/j.vaccine.2023.09.036.","journal-title":"Vaccine"},{"key":"2969_CR20","doi-asserted-by":"publisher","first-page":"16","DOI":"10.3390\/vaccines13010016","volume":"13","author":"C Signorelli","year":"2024","unstructured":"Signorelli C, Pennisi F, D\u2019Amelio AC, Conversano M, Cinquetti S, Blandi L, et al. Vaccinating in Different Settings: Best Practices from Italian Regions. Vaccines (Basel). 2024;13:16. https:\/\/doi.org\/10.3390\/vaccines13010016.","journal-title":"Vaccines (Basel)"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02969-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-026-02969-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02969-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:41:24Z","timestamp":1790671284000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-026-02969-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":20,"alternative-id":["2969"],"URL":"https:\/\/doi.org\/10.1007\/s15010-026-02969-7","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"15 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}