What is your approach to a patient with undetectable MMR titers checked prior to or during immunosuppression and a history of MMR vaccination in childhood?

What steps do you take when managing a patient with undetectable MMR titers checked prior to or during immunosuppression and a history of MMR vaccination in childhood?

• Revaccinating with one dose of MMR if there are at least 28 days before planned immunosuppression and no contraindications to a live vaccine
• Accepting the risk and proceeding without revaccination if there is not enough time to vaccinate or if the patient is high on the transplant list, after discussing with the interdisciplinary team
• Encouraging close contacts, family, and caregivers to complete age-appropriate vaccinations to protect the patient
• Other