Vaccination coverage in children with juvenile idiopathic arthritis, inflammatory bowel diseases, and healthy peers: Cross-sectional electronic survey data

Abstract

BACKGROUND Patients with immune-mediated diseases, such as juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are at increased risk of developing infections, due to disease-related immune dysfunction and applying of immunosuppressive drugs. AIM To evaluate vaccine coverage in patients with IBD and JIA, and compare it with healthy children. METHODS In the cross-sectional study we included the data from a questionnaire survey of 190 Legal representatives of children with JIA ( n = 81), IBD ( n = 51), and healthy children (HC, n = 58). An electronic online questionnaire was created for the survey. RESULTS There were female predominance in JIA patients and younger onset age. Parents of JIA had higher education levels. Employment level and family status were similar in the three studied groups. Patients with JIA and IBD had lower vaccine coverage, without parental rejection of vaccinations in IBD, compare to JIA and healthy controls. The main reason for incomplete vaccination was medical conditions in IBD and JIA. IBD patients had a lower rate of normal vaccine-associated reactions compared to JIA and HC. The encouraging role of physicians for vaccinations was the lowest in JIA patients. IBD patients had more possibilities to check antibodies before immune-suppressive therapy and had more supplementary vaccinations compared to JIA and HC. CONCLUSION JIA and IBD patients had lower vaccine coverage compared to HC. Physicians' encouragement of vaccination and the impossibility of discus about future vaccinations and their outcomes seemed the main factors for patients with immune-mediated diseases, influencing vaccine coverage. Further investigations are required to understand the reasons for incomplete vaccinations and improve vaccine coverage in both groups, especially in rheumatic disease patients. The approaches that stimulate vaccination in healthy children are not always optimal in children with immune-mediated diseases. It is necessary to provide personalized vaccine-encouraging strategies for parents of chronically ill children with the following validation of these technics.

Parents’ Uptake and Willingness towards Recommended Vaccinations for Their Children with Underlying Chronic Medical Conditions in Italy

“…However, despite these recommendations, pneumococcal, meningococcal B and ACWY vaccination uptake is suboptimal among children aged 48 months, still lower than the required rate of 95%, with the values of 91%, 73.7%, and 48.6%, respectively [ 6 ]. This data is alarming because even lower coverage rates have been observed among children with chronic medical conditions compared to those who are healthy [ 7 , 8 , 9 ]. This makes vaccine uptake a crucial public health priority for children with chronic medical conditions.…”

“…It is well known that the intentions of parents toward vaccinations and their related reasons are extremely relevant for achieving higher coverage rates. Previous investigations have focused their attention on the attitudes and behaviors of parents in relation to different vaccinations for their children with chronic medical conditions [ 7 , 8 , 10 , 11 ], but to the best of our knowledge only few surveys have examined this topic in Italy [ 12 , 13 ]. Undoubtedly, this information is extremely important for the development of vaccination campaigns for fostering acceptance.…”