Vaccination coverage of children with rheumatic diseases compared with healthy controls: a retrospective case-control study

ABSTRACT

Objective

To reveal the vaccination status of patients with pediatric rheumatic disease (PedRD) and to compare this with healthy controls.

Methods

The electronic health records of the Ministry of Health regarding the vaccination status of children with PedRD followed in a tertiary hospital were analyzed cross-sectionally and compared with their healthy controls. The missing vaccines were reported according to individual, age-appropriate schedule and causes of skipped vaccines in both groups were investigated with an online survey.

Results

The vaccination rate of patients in the last examination was 71.4% (90/126) and 95.7% (110/115) in healthy controls (p < 0.001). Measles-mumps-rubella vaccine, diphtheria, the administration rates of the second dose of tetanus-acellular pertussis-inactivated polio and Haemophilus influenzae type B, chickenpox, and hepatitis A vaccines were significantly lower in patients than in controls (p values 0.004, 0.02, 0.01, 0.013, respectively). The pre-diagnosis incomplete vaccination proportion was significantly higher in the patient group (16.6%) than in healthy controls (4.3%) (p = 0.002). In the patient group, the proportion of incomplete live-attenuated vaccines after diagnosis (25%) was more than pre-diagnosis (61.1%) (p = 0.04), while the proportion of incomplete non-live vaccines before and after diagnosis was similar (47.2% and 50%, respectively) (p = 0.73). The major reasons for missed vaccines were physicians’ recommendations (15.6%), the presence of PedRD diagnosis (12.5%), and the drugs used (12.5%).

Conclusion

Vaccination coverage of PedRD patients has been shown to lag behind the routine vaccination schedule (71.4%). In addition to new recommendations, electronic health system records for vaccination may be appropriate for the follow-up of these patients, and the addition of reminder alerts may be useful to reduce the rate of missed vaccinations.

KEYWORDS:

• Vaccination coverage
• children
• rheumatic disease
• missing vaccine
• incomplete vaccine

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors contributions

OA, FD, and NAA designed the form of the study. OA and NAA prepared the initial draft of the article. All authors contributed to data collection, analysis, and interpretation of data, providing comments on the draft article and final approval of the article.

Ethics statement

This study was performed in line with the principles of the Declaration of Helsinki. Ethics committee approval (number: 96436) was obtained from Istanbul University, Faculty of Medicine. Due to the retrospective nature of the study, obtaining written informed consent from the patients was not required.

Data availability statement

The data underlying this article will be shared on reasonable request to the corresponding author.

Supplementary Material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00325481.2023.2287988

Additional information

Funding

This paper was not funded.