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Immunization status of patients with spinal muscular atrophy receiving nusinersen therapy
Mehmet Can Yeşilmen1, Çağatay Günay1, Gamze Sarıkaya Uzan1
1Department of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Insights
Children with spinal muscular atrophy (SMA) show low vaccination rates, particularly those with SMA type 1. Nusinersen therapy may impact immunization status, highlighting the need for improved vaccine compliance in these vulnerable pediatric patients.
Area of Science:
- Pediatric Neurology
- Immunology
- Public Health
Background:
- Children with chronic neurological conditions like spinal muscular atrophy (SMA) are at higher risk for vaccine-preventable diseases.
- Evaluating immunization status in pediatric SMA patients is crucial for understanding their vulnerability.
Purpose of the Study:
- To assess the age-appropriate immunization status in pediatric patients with SMA.
- To investigate the relationship between nusinersen therapy and vaccination compliance in this population.
Main Methods:
- A cross-sectional prospective study included 32 children with SMA receiving nusinersen.
- Data collected included SMA type, nusinersen treatment phase, and adherence to the National Immunization Program (NIP).
- Influenza vaccination status and physician recommendations were also recorded.
Main Results:
- Higher rates of under-vaccination were observed in SMA type 1 patients compared to SMA types 2-3.
- Only 9.3% of patients received the influenza vaccine, with 40.6% of parents never receiving a recommendation.
- Under-vaccination rates for several routine vaccines were higher in patients on nusinersen maintenance therapy versus loading doses.
Conclusions:
- Pediatric patients with SMA exhibit suboptimal immunization rates and poor adherence to vaccination schedules.
- Healthcare providers must prioritize routine vaccinations for children with SMA, ensuring they receive equivalent preventive care as healthy children.
Background:
Children with chronic neurological diseases, including spinal muscular atrophy (SMA), are particularly susceptible to vaccine-preventable infections. We aimed to evaluate the age-appropriate immunization status and its relationship with nusinersen therapy in pediatric patients with SMA.
Methods:
Children with SMA who received nusinersen treatment were included in this cross-sectional prospective study. Data were collected on SMA characteristics, nusinersen therapy, vaccination status according to the National Immunization Program (NIP), administration, and influenza vaccination recommendation.
Results:
A total of 32 patients were enrolled. In patients with SMA type 1, the frequency of under-vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically higher than in patients with SMA type 2-3 (p<0.001). The influenza vaccine was administered to only 9.3% of patients and was never recommended to 13 (40.6%) parents. The frequency of under-vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically higher in patients receiving nusinersen maintenance therapy than in those with loading doses (p<0.001). Physician recommendations for influenza and pneumococcal vaccines were significantly higher in the nusinersen maintenance group (p = 0.029). There was no statistical significance between the groups in terms of administration of influenza and pneumococcal vaccines (p = 0.470).
Conclusion:
Children with SMA had lower immunization rates and poor compliance with immunization programs. Clinicians should ensure that children with SMA receive the same preventive health measures as healthy children, including vaccinations.
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