Immunisation deferral practices surrounding congenital heart surgery

Area of Science:

• Pediatric Cardiology
• Immunology
• Public Health

Background:

• Perioperative immunization administration around congenital heart surgery (CHD) is controversial.
• Delayed immunizations increase risks for vaccine-preventable illnesses in medically fragile children with CHD.
• Limited research suggests perioperative immunizations may be safe and effective.

Purpose of the Study:

• To survey current perioperative immunization practices in centers performing congenital heart surgery.
• To identify variations and trends in immunization deferral policies.
• To assess the potential risks associated with current practices.

Main Methods:

• Survey of member centers of the Pediatric Acute Care Cardiology Collaborative.
• Analysis of survey responses using descriptive statistics.

Main Results:

• 35/46 (76%) centers responded, revealing significant variation in practices.
• Most centers (66%) defer immunizations pre-surgery, and 89% defer post-surgery.
• Post-operative deferral is often linked to cardiopulmonary bypass, with variable durations and exceptions for specific vaccines.

Conclusions:

• The majority of centers defer routine childhood immunizations before and after congenital heart surgery.
• These varying deferral practices pose risks to patients and may be unwarranted.
• Further research is needed to understand the immunological impact and optimal timing of immunizations in this population.