Vaccination of adolescents with chronic medical conditions: Special considerations and strategies for enhancing uptake

Hofstetter, Annika M.; LaRussa, Philip; Rosenthal, Susan L.

doi:10.1080/21645515.2015.1067350

Cited by 19 publications

(12 citation statements)

References 128 publications

(44 reference statements)

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“…Furthermore, studies have often linked delays in providing vaccinations, or non-vaccination, to doctors' lack of knowledge or failure to inform families of the indications for these particular vaccines. 7,8 Vaccination delay is defined as a notable difference between the actual and recommended age of vaccination, and it can be harmful. 9 The main objective of this study was to measure the vaccine coverage rates of children with chronic diseases in our university hospital.…”

Section: Introductionmentioning

confidence: 99%

Vaccination coverage of children with chronic diseases is inadequate especially for specifically recommended vaccines

Diallo¹,

Santal²,

Lagrée³

et al. 2020

Acta Paediatrica

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Aim: Our objectives were to measure the vaccine coverage rates for children with chronic diseases as well as the prevalence of potentially harmful delays for generally recommended vaccines. We also identified the factors influencing non-adherence to vaccines specifically recommended for chronic conditions. Methods: Three non-interventional point-prevalence surveys were performed in 2014 in all paediatric units at Lille University Hospital among children aged 2 months-18 years with chronic diseases and vaccination data. Vaccine coverage and delays for generally recommended vaccines were studied. The children who were up-to-date and those under-vaccinated for specifically indicated vaccines were compared and the factors potentially associated with under-vaccination were studied with multivariable analysis. Results: We screened 682 patients: of 207 with chronic diseases, mainly neurological, muscular and respiratory disorders, 146 had vaccination data. Only 47% (95% confidence interval 39-55) were up-to-date for all generally recommended vaccinations; potentially harmful vaccination delays were high (26%-75%). Only 11% of the 81% of patients for whom some vaccines were specifically recommended were upto-date. Low maternal education level was significantly associated with under-vaccination (adjusted odds ratio 10.5, 95% confidence interval 1.3-86.9, P = .03). Conclusion: This study showed inadequate vaccine coverage rates and significant delays among children with chronic diseases.

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Section: Introductionmentioning

confidence: 99%

Vaccination coverage of children with chronic diseases is inadequate especially for specifically recommended vaccines

Diallo¹,

Santal²,

Lagrée³

et al. 2020

Acta Paediatrica

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“…They do not receive systematic training for vaccinology and lack clinical experience, which prevents them from making the correct judgment for the precautions and contraindications of vaccination for CSHCN (21–24). In addition, due to the negative reports about vaccines and the lack of knowledge regarding the risk of vaccine preventable diseases, parents usually have many concerns for the use of vaccines (5). Finally, for clinical specialists, they have more concerns regarding AEFI if the child are suffering a chronic disease, such as seizures or suppressed immunologic system responses (25).…”

Section: Discussionmentioning

confidence: 99%

“…In order to explore new strategies of improving the vaccination coverage of CSHCN, it was important to identify the main correlative factors that affect vaccination of this population. In the United States, demographic characteristics such as age, gender, insurance status are considered to be associated with vaccination coverage in youths with special health care (5, 26). In our study, we found that gender, family history of related diseases and history of mild or non-vaccine-related allergies were not strong factors influencing vaccination recommendations, which was consistent with the recommendation from “the guidelines for immunization of ACIP” and “Chinese Pharmacopeia”; nevertheless, we found that age, history of AEFI and the number of combined diseases were indicated as strong factors influencing vaccination recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…The underlying factors of incomplete vaccination are complicated. A previous literature review stated that demographic characteristics such as age, gender, insurance status are correlates of receiving recommended vaccines (5). Some other studies focusing on the impact of some socioeconomic factors on vaccination and indicated that the outreach of medical support programs targeted to CSHCN, family's socioeconomic status and parental educational level are all related to the vaccination coverage (3, 4, 6).…”

Section: Introductionmentioning

confidence: 99%

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Incomplete Vaccination Among Children With Special Health Care Needs in Zhejiang, China: Analysis of Retrospective Data

Wang

et al. 2019

Front. Pediatr.

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Objective: There is a lack of data relating to vaccination of children with special health care needs (CSHCN) and its influencing factors in China. We investigated the disease spectrum of CSHCN at the Vaccination Consultation Clinic in Zhejiang province as well as the underlying factors of vaccination recommendations of these children. Methods: In this study, we retrospectively analyzed the data of 4,525 CSHCN, who visited to our clinic for a vaccination consultation from January 1, 2016 to May 30, 2018. Descriptive data were presented as mean ± standard deviation (SD) and percentages. Multivariate analysis was performed with non-conditional bivariate logistic regression to identify the underlying factors of vaccination recommendations. Subsequent information regarding the following vaccination and the occurrence of AEFI were also collected and analyzed. Results: The main diseases consulted were those relating to the circulatory and nervous systems as well as neonatal diseases. The distribution of diseases varied by age: 53.6% infants under 12 months were counseled for circulatory system diseases, while 44.6% children aged 12~24 months and 54.7% children over 25 months were counseled for nervous system diseases. According to the evaluation reports issued by the consultation clinic, 75.0% of CSHCN were recommended to be vaccinated normally, 21.2% were recommended to defer specific vaccination, while only 3.8% were recommended to defer all vaccinations. In logistic regression analysis, age, history of adverse events following immunization (AEFI) and the number of diseases combined were all strong correlative factors for vaccination recommendations. Children who were aged over 25-month-old (OR = 1.34, 95%CI: 1.11–1.61) or had a history of AEFI (OR = 3.77, 95%CI: 2.83~5.01) or those who had numerous diseases combined (OR = 2.00, 95%CI: 1.46~2.75) tended to have a higher rate of deferred vaccination recommendation. Among those CSHCN who received nationally-recommended vaccines, the estimated AEFI rate was 24.29/100 000. No uncommon or rare serious adverse reactions were detected. Conclusion: Age, history of AEFI, and the number of diseases combined were important factors that affected the vaccination recommendations of CSHCN. Most CSHCN can be safely vaccinated according to the nationally-recommended schedule.

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“…141516 These studies also underpin the importance of routine and annual immunizations for children with medical complexity to decrease infection-related risks. 1718 …”

mentioning

confidence: 99%

Anticipatory Guidance on the Risks for Unfavorable Outcomes among Children with Medical Complexity

Edwards

2017

The Journal of Pediatrics

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Vaccination of adolescents with chronic medical conditions: Special considerations and strategies for enhancing uptake

Cited by 19 publications

References 128 publications

Vaccination coverage of children with chronic diseases is inadequate especially for specifically recommended vaccines

Vaccination coverage of children with chronic diseases is inadequate especially for specifically recommended vaccines

Incomplete Vaccination Among Children With Special Health Care Needs in Zhejiang, China: Analysis of Retrospective Data

Anticipatory Guidance on the Risks for Unfavorable Outcomes among Children with Medical Complexity

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