Evaluation of immunization status in patients with cerebral palsy: a multicenter CP-VACC study

Abstract

Children with chronic neurological diseases,including cerebral palsy(CP)are especially susceptible to vaccine-preventable infections and face an increased risk of severe respiratory infections and decompensation of their disease.This study aims to examine age-appropriate immunization status and related factors in the CP population of our country. This cross-sectional prospective multicentered survey study included 18 pediatric neurology clinics around Turkey,wherein outpatients children with CP were included in the study.Data on patient and CP characteristics,concomitant disorders as well as vaccination status included in the National Immunization Program(NIP),administration and recommendation of in uenza vaccine were collected at a single visit.A total of 1194 patients were enrolled.Regarding immunization records,the most frequently administrated and schedule completed vaccines were BCG(90.8%),hepatitis B(88.9%)and oral poliovirus vaccine (88.5%).MMR was administered to 77.3% and DTaP-IPV-HiB was administered to 60.5% of patients.For the pneumococcal vaccines,54.1% of children had received PCV in the scope of the NIP, and 15.2% of children were not fully vaccinated for their age.The in uenza vaccine, was administered only to 3.4% of the patients at any time and had never been recommended to 1122 parents(93.9%).In the patients with severe(grade 4 and 5)motor dysfunction,the frequency of incomplete/none vaccination of hepatitis B,BCG, DTaP-IPV-HiB,OPV,MMR were statistically more common than mild to moderate(grade 1-3)motor dysfunction(p = 0.003, p < 0.001, p < 0.001, p < 0.00, and p < 0.001, respectively).In uenza vaccine recommendation by physicians was higher in the severe motor dysfunction group and the difference was statistically signi cant(p = 0.029).Children with CP had lower immunization rates and incomplete immunization programs.Clinicians must ensure children with CP receive the same preventative health measures as healthy children,including vaccines.

Immunization Status in Children with Cerebral Palsy and Their Household Members, and Parental Beliefs and Attitudes About Childhood, Adulthood, and COVID-19 Immunizations

“…Our study also showed that the age at diagnosis of CP was ≤ 3 years in all children and all were fully vaccinated. A recent study from Turkey suggested that the frequency of incomplete/no routine immunizations, except pneumococcal immunization, is higher in patients with severe motor dysfunction than in CP children with mild to moderate motor dysfunction ( CP ) (7). In our study, all children at each level of the Gross Motor Function Classification System (GMFCS) were fully vaccinated, possibly because there were no contraindications to vaccines and no history of serious adverse events after immunization in the participants in this study.…”

“…In this study, parents were not adequately informed by healthcare professionals about optional childhood vaccines, and none of the children with CP received the full series of optional childhood vaccines. In Turkey, the influenza vaccine was never recommended for 93.9% of children with CP (7). The percentage of Turkish family physicians and pediatricians who recommend the meningococcal conjugate vaccine to their patients was given as 57.5% and 71.2%, respectively (24).…”

“…The diphtheria-tetanus-acellular pertussis (DTaP), inactivated polio, hemophilus the influenza type B, and pneumococcal conjugate vaccines were administered in ≤60% of patients. For pneumococcal vaccines, 15.2% of children were not fully vaccinated for their age, and influenza vaccine was administered to only 3.4% at any time (7).…”