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Vaccination coverage among paediatric onco-haematological patients: an Italian cross-sectional study
Paola Giordano1, Nicola Santoro2, Pasquale Stefanizzi1
1Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy.
Insights
Pediatric patients with cancer or blood disorders often miss recommended vaccinations, increasing infection risk. Improving communication and hospital-based vaccine administration can enhance immunization compliance in these vulnerable children.
Area of Science:
- Pediatric Oncology
- Hematology
- Infectious Disease Prevention
Background:
- Children with onco-hematological diseases face higher infection risks.
- Vaccines can mitigate infection risk, but adherence is often poor in these patients.
- Understanding vaccination noncompliance is crucial for improving patient outcomes.
Purpose of the Study:
- To determine if a cancer or hematological diagnosis influences adherence to recommended vaccination schedules.
- To assess vaccination coverage and identify risk factors for missed immunizations in pediatric onco-hematological patients.
Main Methods:
- A convenience sample of 228 children treated between 2005-2015 at a pediatric hospital was analyzed.
- Immunization status was retrieved from the Apulia regional immunization database (GIAVA).
- A post-diagnosis adherence score was calculated to evaluate vaccination compliance.
Main Results:
- Vaccination coverage varied: DTaP-IPV-Hep B-Hib (87.7%), pneumococcal (68.7%), MMR (75.8%), and varicella (75.1%).
- The average age at vaccination was higher than recommended by the National Vaccination Plan.
- Oncological diagnosis and older age at enrollment were identified as risk factors for missed vaccinations.
Conclusions:
- The overall vaccination status of pediatric onco-hematological patients is suboptimal.
- Interventions focusing on provider communication and hospital-based vaccine administration are needed.
- Improving vaccination compliance is essential for reducing infection risk in this population.
Abstract:
Children with onco-hematological diseases are at increased risk of infection. However, this risk can in part be controlled or reduced using currently available vaccines. Despite available evidence, in patients diagnosed with a hematological or oncological disease the vaccination schedule is often inappropriately discontinued. In this study we evaluated whether the diagnosis of an oncological or hematological disease is a determinant of noncompliance with recommended vaccinations.The study was carried out between March and April 2019. The population was composed of a convenience sample of 228 children cared for in the Pediatric Oncology Department and Pediatric Hematology Department of the Policlinico Giovanni XXIII Pediatric Hospital (Bari, Italy) from 2005 to 2015. Information on the immunization status of the patients was obtained from the Apulia regional immunization database (GIAVA). A post-diagnosis adherence score was calculated.The vaccination coverage was 87.7% for the DTaP-IPV-Hep B-Hib vaccine (3 doses), 68.7% for the pneumococcal vaccine (3 doses), 75.8% for the MMR vaccine (2 doses) and 75.1% for the varicella vaccine (2 doses). The average age at vaccination was older than that recommended by the National Vaccination Plan. A diagnosis of oncological disease and an older age at enrollment were risk factors for missing vaccinations. These results showed that the overall vaccination status of pediatric onco-hematological patients is suboptimal. Improving provider communication and establishing the hospital as the primary environment for vaccine administration may lead to better vaccination compliance in this group.
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