Vaccination and safe living strategies for solid organ transplant candidates and recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

These updated guidelines of the American Society of Transplantation Infectious Diseases Community of Practice review safe living practices, including routine vaccinations and travel vaccinations, general travel advice, as well as nonpharmacologic strategies for safe living. General principles of vaccination as well as the use of specific vaccines in this population are discussed. Vaccination status should be reviewed and updated in the pretransplant setting and when travel is planned. The optimal timing of vaccination posttransplant should be taken into account. There is accumulating data that live-attenuated vaccines can also be given to select posttransplant pediatric and young adult patients. Since the last update of the guidelines in 2019, several new vaccines have been recommended, such as those for coronavirus disease 2019 and respiratory syncytial virus. In addition, newer formulations of pneumococcal, meningococcal, and hepatitis B vaccinations are available. There are expanded age indications for the recombinant zoster vaccine. Close contacts of transplant patients can receive most routine live and inactivated vaccines. For travel, location, duration, and activity during the trip determine the vaccine requirements as well as the need for malaria chemoprophylaxis. Other strategies for safe living include considerations for food, water, pets, and sexual activity. Detailed recommendations surrounding these are included in these guidelines.