Department of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Department of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Arch Pediatr. 2023 Jul;30(5):291-296. doi: 10.1016/j.arcped.2023.03.006. Epub 2023 May 3.
Children with chronic neurological diseases, including spinal muscular atrophy (SMA), are particularly susceptible to vaccine-preventable infections. We aimed to evaluate the age-appropriate immunization status and its relationship with nusinersen therapy in pediatric patients with SMA.
Children with SMA who received nusinersen treatment were included in this cross-sectional prospective study. Data were collected on SMA characteristics, nusinersen therapy, vaccination status according to the National Immunization Program (NIP), administration, and influenza vaccination recommendation.
A total of 32 patients were enrolled. In patients with SMA type 1, the frequency of under-vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically higher than in patients with SMA type 2-3 (p<0.001). The influenza vaccine was administered to only 9.3% of patients and was never recommended to 13 (40.6%) parents. The frequency of under-vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically higher in patients receiving nusinersen maintenance therapy than in those with loading doses (p<0.001). Physician recommendations for influenza and pneumococcal vaccines were significantly higher in the nusinersen maintenance group (p = 0.029). There was no statistical significance between the groups in terms of administration of influenza and pneumococcal vaccines (p = 0.470).
Children with SMA had lower immunization rates and poor compliance with immunization programs. Clinicians should ensure that children with SMA receive the same preventive health measures as healthy children, including vaccinations.
患有慢性神经疾病的儿童,包括脊髓性肌萎缩症(SMA),特别容易感染可通过疫苗预防的疾病。我们旨在评估 SMA 患儿的适龄免疫状况及其与 nusinersen 治疗的关系。
本横断面前瞻性研究纳入了接受 nusinersen 治疗的 SMA 患儿。收集了 SMA 特征、nusinersen 治疗、根据国家免疫计划(NIP)接种疫苗、接种和流感疫苗推荐的数据。
共纳入 32 例患者。在 SMA 1 型患者中,乙肝、卡介苗、DTaP-IPV-HiB、OPV 和 MMR 的未接种率明显高于 SMA 2-3 型患者(p<0.001)。只有 9.3%的患儿接种了流感疫苗,13 例(40.6%)患儿的家长从未被建议接种流感疫苗。接受 nusinersen 维持治疗的患儿乙肝、卡介苗、DTaP-IPV-HiB、OPV 和 MMR 的未接种率明显高于接受负荷剂量的患儿(p<0.001)。流感疫苗和肺炎球菌疫苗的医生推荐率在 nusinersen 维持治疗组明显更高(p=0.029)。两组患儿在流感疫苗和肺炎球菌疫苗的接种率方面无统计学差异(p=0.470)。
SMA 患儿的免疫接种率较低,且对免疫接种计划的依从性较差。临床医生应确保 SMA 患儿接受与健康儿童相同的预防保健措施,包括接种疫苗。