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青少年特发性关节炎、炎症性肠病患儿及健康同龄人的疫苗接种覆盖率:横断面电子调查数据。

Vaccination coverage in children with juvenile idiopathic arthritis, inflammatory bowel diseases, and healthy peers: Cross-sectional electronic survey data.

作者信息

Makarova Elizaveta, Khabirova Aygul, Volkova Natalia, Gabrusskaya Tatiana, Ulanova Natalia, Sakhno Larisa, Revnova Maria, Kostik Mikhail

机构信息

Department of Polyclinic Pediatrics, Saint-Petersburg State Pediatric Medical University, Saint-Petersburg 194100, Russia.

Department of Hospital Pediatrics, Saint-Petersburg State Pediatric Medical University, Saint-Petersburg 194100, Russia.

出版信息

World J Clin Pediatr. 2023 Mar 9;12(2):45-56. doi: 10.5409/wjcp.v12.i2.45.

Abstract

BACKGROUND

Patients with immune-mediated diseases, such as juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are at increased risk of developing infections, due to disease-related immune dysfunction and applying of immunosuppressive drugs.

AIM

To evaluate vaccine coverage in patients with IBD and JIA, and compare it with healthy children.

METHODS

In the cross-sectional study we included the data from a questionnaire survey of 190 Legal representatives of children with JIA ( = 81), IBD ( = 51), and healthy children (HC, = 58). An electronic online questionnaire was created for the survey.

RESULTS

There were female predominance in JIA patients and younger onset age. Parents of JIA had higher education levels. Employment level and family status were similar in the three studied groups. Patients with JIA and IBD had lower vaccine coverage, without parental rejection of vaccinations in IBD, compare to JIA and healthy controls. The main reason for incomplete vaccination was medical conditions in IBD and JIA. IBD patients had a lower rate of normal vaccine-associated reactions compared to JIA and HC. The encouraging role of physicians for vaccinations was the lowest in JIA patients. IBD patients had more possibilities to check antibodies before immune-suppressive therapy and had more supplementary vaccinations compared to JIA and HC.

CONCLUSION

JIA and IBD patients had lower vaccine coverage compared to HC. Physicians' encouragement of vaccination and the impossibility of discus about future vaccinations and their outcomes seemed the main factors for patients with immune-mediated diseases, influencing vaccine coverage. Further investigations are required to understand the reasons for incomplete vaccinations and improve vaccine coverage in both groups, especially in rheumatic disease patients. The approaches that stimulate vaccination in healthy children are not always optimal in children with immune-mediated diseases. It is necessary to provide personalized vaccine-encouraging strategies for parents of chronically ill children with the following validation of these technics.

摘要

背景

免疫介导性疾病患者,如幼年特发性关节炎(JIA)和炎症性肠病(IBD),由于疾病相关的免疫功能障碍和免疫抑制药物的应用,发生感染的风险增加。

目的

评估IBD和JIA患者的疫苗接种覆盖率,并与健康儿童进行比较。

方法

在这项横断面研究中,我们纳入了对190名JIA患儿(n = 81)、IBD患儿(n = 51)和健康儿童(HC,n = 58)的法定代表人进行问卷调查的数据。为此调查创建了一份电子在线问卷。

结果

JIA患者以女性为主,发病年龄较小。JIA患者的父母受教育程度较高。三个研究组的就业水平和家庭状况相似。与JIA和健康对照组相比,JIA和IBD患者的疫苗接种覆盖率较低,IBD患者中没有家长拒绝接种疫苗。IBD和JIA中疫苗接种不完全的主要原因是身体状况。与JIA和HC相比,IBD患者正常疫苗相关反应的发生率较低。医生对疫苗接种的鼓励作用在JIA患者中最低。与JIA和HC相比,IBD患者在免疫抑制治疗前检查抗体的可能性更大,补充接种疫苗的次数更多。

结论

与HC相比,JIA和IBD患者的疫苗接种覆盖率较低。医生对疫苗接种的鼓励以及无法讨论未来疫苗接种及其结果似乎是免疫介导性疾病患者影响疫苗接种覆盖率的主要因素。需要进一步调查以了解疫苗接种不完全的原因,并提高两组,特别是风湿性疾病患者的疫苗接种覆盖率。在健康儿童中促进疫苗接种的方法在免疫介导性疾病儿童中并不总是最佳的。有必要为慢性病患儿的家长提供个性化的疫苗鼓励策略,并对这些技术进行后续验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d88/10075019/ac728f8e39cc/WJCP-12-45-g001.jpg

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