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Special Immunization Service: A 14-year experience in Italy
Daniele Donà1, Susanna Masiero2, Sara Brisotto2
1Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, Padua, Italy.
Insights
A Special Immunization Service (SIS) improved vaccination compliance in high-risk children. The service demonstrated safety, with few mild adverse events, enhancing vaccine coverage.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- Growing concerns about vaccine safety impact vaccination schedule adherence.
- Assessing vaccination risks and compliance is crucial for public health.
Purpose of the Study:
- To evaluate vaccination-related risks in children attending a Special Immunization Service (SIS).
- To determine the impact of the SIS at the Pediatric Emergency Department (PED) on vaccination compliance.
Main Methods:
- Retrospective cohort study of children attending the SIS from 2002-2015.
- The SIS included a pre-vaccination clinic (SIS-C) and a vaccination area (SIS-PED).
- Data collected included admission criteria, vaccinations, adverse events, and follow-up for plan completion.
Main Results:
- 359 children received 560 vaccine administrations; 27.2% admitted for prior adverse events, 42.7% for allergies.
- Only 2.7% of vaccinations resulted in mild adverse events.
- Vaccination at SIS-PED led to 96.3% completion of vaccination plans versus 55.5% for those not vaccinated at SIS-PED.
Conclusions:
- Vaccination at the SIS-PED significantly increased vaccination plan completion rates.
- The SIS is a safe and effective service for vaccinating high-risk children, improving vaccine coverage.
Background:
Concerns regarding vaccine safety are increasing along with lack of compliance to vaccination schedules. This study aimed to assess vaccination-related risks and the impact of a Special Immunization Service (SIS) at the Pediatric Emergency Department (PED) of Padua on vaccination compliance among participants.
Materials And Methods:
This retrospective cohort study included all children attending the SIS from January 1st 2002 to December 31st 2015. The Service is divided into a clinic (SIS-C) where all referred children undergo a pre-vaccination visit and an area within the Pediatric Emergency Department (SIS-PED) where children are vaccinated if indicated. During each SIS-C visit, age, gender, admission criteria and scheduled vaccinations were recorded, with any vaccine-related adverse events captured during SIS-PED visits. Follow-up was conducted to evaluate vaccination plan completion.
Results:
359 children received 560 vaccine administrations (41.3% MMR/MMRV, 17.5% hexavalent) at the SIS during the 14 year study. Admission criteria were adverse events after previous vaccination (immediate, IgE/not IgE mediated, and late) in 27.2% of cases, non-anaphylactic allergies (mostly egg allergy) in 42.7% and anaphylaxis in 10.3%. After vaccination, 15/560 (2.7%) mild adverse events were observed. 96.3% of children vaccinated at least once at the SIS-PED and available for follow-up completed their vaccination plan, in contrast to 55.5% of children referred to the SIS-C who were not vaccinated in SIS-PED.
Conclusions:
For children referred to SIS-C and available for follow-up, vaccination in SIS-PED was associated with more frequent completion of vaccination plans, indicating a benefit of the service to vaccine coverage. The low number and mild severity of adverse events reported after vaccination of high-risk children in SIS-PED attest to the safety of the service.
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