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Evaluating Vaccination Status and Barriers in Children with Rheumatic Diseases
Shine Vazhappilly1, Babatope O Adebiyi1, Racheal Githumbi1
1Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
Insights
Children with rheumatic diseases (RD) and healthy controls (HC) have similar vaccination rates, but influenza vaccine uptake is low. Concerns about vaccine safety in RD patients hinder immunization completeness.
Area of Science:
- Pediatric Rheumatology
- Immunology
- Public Health
Background:
- Limited data exists on vaccination status and barriers in children with rheumatic diseases (RD).
- This study compares vaccination rates and identifies immunization challenges in pediatric RD patients versus healthy controls (HC).
Purpose of the Study:
- To evaluate vaccination status in children with RD compared to HC.
- To identify barriers and facilitators to immunization in children with RD.
Main Methods:
- A cross-sectional study involving children with RD and HC at a Canadian tertiary care center.
- Data collected via health records, electronic vaccine databases, and patient/caregiver questionnaires.
- Descriptive statistical analysis was employed.
Main Results:
- Most recommended vaccines were administered at high rates (>80%), except for the influenza vaccine (34% in RD vs. 21% in HC).
- Vaccinations were withheld in 31% of RD children and 27% of HC due to disease activity, provider advice, or safety concerns.
- Family doctors were the primary source of vaccination information for both groups, with high satisfaction.
Conclusions:
- Influenza vaccination gaps exist in children with RD and HC.
- Perceived vaccine safety concerns, despite understanding contraindications, limit vaccination completeness in RD patients.
- Healthcare providers should proactively educate patients and caregivers on vaccine safety and necessity.
Abstract:
Background: This study aims to evaluate the vaccination status of children with rheumatic diseases (RD) compared to healthy controls (HC) and immunization barriers, as studies examining the vaccination status and factors promoting or hindering vaccination among children RD remain limited. Methods: A cross-sectional study was conducted on children with RD (in a rheumatology clinic) and HC (in a fracture clinic) at a tertiary care center in Canada. Demographics, diagnosis, treatments, and vaccine status were obtained from health records and a provincial electronic vaccine database. A patient/caregiver questionnaire was used to capture perceived immunization barriers, concerns, and satisfaction. Descriptive statistical methods were used for analysis. Results: The study involved 144 children with RD and 111 HC. Data from 94 children with RD and 86 HC, all lifelong Alberta residents, were analyzed for objective vaccination status. Most vaccines were received at rates of 80% or higher, except the influenza vaccine, which had the lowest adherence (34% in RD vs. 21% in HC). In 31% of RD children, vaccinations were withheld due to active disease, healthcare provider advice, or caregiver concerns about side effects. In 27% HC, vaccinations were withheld due to side effects. Both groups primarily relied on their family doctor for vaccination information, and 85% or more expressed satisfaction with the information received. Conclusions: Most children with RD and HC received recommended vaccines, but influenza vaccination gaps were identified. Knowledge about vaccine contraindications in RD is well understood, but perceived safety concerns limit vaccination completeness. Healthcare providers, especially family doctors, pediatricians, and rheumatologists, should be providing education resources for vaccines and be proactive in discussing the safety and necessity of vaccinations.
