Giordano Paola, Santoro Nicola, Stefanizzi Pasquale, Termite Stefano, De Nitto Sara, Bianchi Francesco Paolo, Corallo Paola Carmela, Lassandro Giuseppe, Tafuri Silvio
Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy.
Paediatric Oncology Department, Bari Policlinico General Hospital, Bari, Italy.
Hum Vaccin Immunother. 2021 Mar 4;17(3):818-823. doi: 10.1080/21645515.2020.1797367. Epub 2020 Aug 26.
Children with onco-hematological diseases are at increased risk of infection. However, this risk can in part be controlled or reduced using currently available vaccines. Despite available evidence, in patients diagnosed with a hematological or oncological disease the vaccination schedule is often inappropriately discontinued. In this study we evaluated whether the diagnosis of an oncological or hematological disease is a determinant of noncompliance with recommended vaccinations.The study was carried out between March and April 2019. The population was composed of a convenience sample of 228 children cared for in the Pediatric Oncology Department and Pediatric Hematology Department of the Policlinico Giovanni XXIII Pediatric Hospital (Bari, Italy) from 2005 to 2015. Information on the immunization status of the patients was obtained from the Apulia regional immunization database (GIAVA). A post-diagnosis adherence score was calculated.The vaccination coverage was 87.7% for the DTaP-IPV-Hep B-Hib vaccine (3 doses), 68.7% for the pneumococcal vaccine (3 doses), 75.8% for the MMR vaccine (2 doses) and 75.1% for the varicella vaccine (2 doses). The average age at vaccination was older than that recommended by the National Vaccination Plan. A diagnosis of oncological disease and an older age at enrollment were risk factors for missing vaccinations. These results showed that the overall vaccination status of pediatric onco-hematological patients is suboptimal. Improving provider communication and establishing the hospital as the primary environment for vaccine administration may lead to better vaccination compliance in this group.
患有血液肿瘤疾病的儿童感染风险增加。然而，使用目前可用的疫苗可以部分控制或降低这种风险。尽管有现有证据，但在被诊断患有血液学或肿瘤学疾病的患者中，疫苗接种计划常常被不恰当地中断。在本研究中，我们评估了肿瘤学或血液学疾病的诊断是否是不遵守推荐疫苗接种的决定因素。
该研究于2019年3月至4月进行。研究人群包括2005年至2015年在乔瓦尼二十三世儿童医院（意大利巴里）儿科肿瘤科和儿科血液科接受治疗的228名儿童的便利样本。患者免疫状态信息来自普利亚地区免疫数据库（GIAVA）。计算诊断后的依从性评分。
百白破-灭活脊髓灰质炎病毒-乙肝- Hib疫苗（3剂）的接种覆盖率为87.7%，肺炎球菌疫苗（3剂）为68.7%，麻疹-腮腺炎-风疹疫苗（2剂）为75.8%，水痘疫苗（2剂）为75.1%。疫苗接种的平均年龄高于国家疫苗接种计划推荐的年龄。肿瘤疾病诊断和入组时年龄较大是错过疫苗接种的危险因素。这些结果表明，儿科血液肿瘤患者的总体疫苗接种状况不理想。改善医护人员沟通并将医院确立为疫苗接种的主要场所可能会使该群体的疫苗接种依从性更好。
