Vaccine Coverage Among People With Cystic Fibrosis: A National Multicenter Cross-Sectional Study in Israel

Vaccines are a cornerstone of modern medicine, however, in some regions, low coverage is reported in patients with chronic diseases, including people with cystic fibrosis (pwCF), compared to the general population.

This retrospective multicenter study in Israel included pwCF born after January 1, 2000, and compared them to the general population. Vaccination data were collected from patient databases and the Ministry of Health reports for the general population.

Out of 269 eligible pwCF aged 6 months to 23 years, a total of 173 were included. Coverage for the initial DTaP-IPV-HiB vaccine, administered in the first year of life, was similar between pwCF and the general population (92% compared with 96%, p = 0.23). In contrast, coverage for other routine vaccines given in the first year of life was significantly lower in pwCF: HAV (76% compared with 92%), HBV (85% compared with 96%), and the first dose of MMRV (85% compared with 97%) (all p < 0.001). Booster dose coverage for DTaP-IPV-HiB and MMRV, given at age 6-7 years, was also significantly reduced in pwCF (72% compared with 95% and 68% compared with 96% respectively, p < 0.001). Pneumococcal conjugate vaccine uptake was significantly lower in pwCF (61.8% vs. 94% in the general population p < 0.001), while the 23-valent pneumococcal vaccine was slightly more prevalent among pwCF compared to those with other chronic conditions, although uptake was low in both groups (15% vs. 10%, p = 0.001). Influenza vaccination rates during 3 seasons were significantly higher in pwCF (65%-70% vs. 20-27% in the general population, p < 0.001), whereas COVID-19 vaccine uptake was lower in adolescent pwCF compared to their general population peers (38.5% vs. 57.4%, p = 0.04).

Our study highlights suboptimal vaccine coverage among pwCF, particularly after the first year of life, affecting both routine early-life vaccines and booster doses. Greater awareness and proactive measures are needed to ensure adequate vaccination.