Lloyd Audrey R, Ardura Monica I, Wise Kelly, Chavarin Daniel J, Boyle Brendan, Sivaraman Vidya
Internal Medicine, Division of Infectious Diseases, University of Alabama, Birmingham, AL, United States.
Pediatrics, Divisions of Infectious Disease, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, United States.
Front Pediatr. 2023 Mar 1;11:1103096. doi: 10.3389/fped.2023.1103096. eCollection 2023.
Vaccination of immunocompromised children (ICC) remains suboptimal.
Needs assessment surveys were administered to patients and caregivers during routine ambulatory visits to the rheumatology and gastroenterology clinics at Nationwide Children's Hospital (NCH) from January 1 through August 31, 2018, and to community primary care physicians (PCPs) at their monthly meeting and electronically.
Completed surveys were received for 57 patients 31 with childhood-onset systemic lupus erythematosus (c-SLE) and 26 with inflammatory bowel disease (IBD)) and 30 PCPs. Of the patient cohort, 93% ( = 53) felt their PCP was well informed about vaccines and 84% ( = 47) received vaccinations from either their PCP or local health department. Two patient surveys noted concerns of vaccine safety. Among the 30 responses completed by PCPs 50% ( = 15) preferred to provide all vaccines themselves, however, only 40% ( = 12) of PCPs felt "very confident" when providing vaccines to ICC. Further, 83% ( = 25) did not stock the 23-valent pneumococcal vaccine and only 27% ( = 8) routinely recommended vaccination of household contacts.
Our study found a discordance between parent and PCP comfort in vaccinating ICC, highlighting an important barrier to vaccination in this patient population. In our cohort of patients, vaccine hesitancy was not a barrier to vaccination.
免疫功能低下儿童（ICC）的疫苗接种情况仍不理想。
2018年1月1日至8月31日期间，在全国儿童医院（NCH）的风湿病和胃肠病科门诊对患者及其护理人员进行了需求评估调查，并在社区初级保健医生（PCP）的月度会议上及通过电子方式对他们进行了调查。
共收到57名患者（31名儿童期起病的系统性红斑狼疮（c-SLE）患者和26名炎症性肠病（IBD）患者）及30名PCP的完整调查问卷。在患者队列中，93%（n = 53）的患者认为其PCP对疫苗充分了解，84%（n = 47）的患者从其PCP或当地卫生部门接种了疫苗。两份患者调查问卷提到了对疫苗安全性的担忧。在PCP完成的30份回复中，50%（n = 15）的PCP更愿意自己提供所有疫苗，然而，只有40%（n = 12）的PCP在为ICC提供疫苗时感到“非常有信心”。此外，83%（n = 25）的PCP没有储备23价肺炎球菌疫苗，只有27%（n = 8）的PCP常规建议对家庭接触者进行疫苗接种。
我们的研究发现家长和PCP在ICC疫苗接种方面的舒适度存在差异，这凸显了该患者群体疫苗接种的一个重要障碍。在我们的患者队列中，疫苗犹豫并非疫苗接种的障碍。
