Barış Hatice Ezgi, Kepenekli Eda, Akbolat Sakar Fikriye İrem, Ütük Burak, Şahin Pınar, Ergenç Zeynep, Tokuç Ayşe Gülnur, Koç Ahmet, Karakoç-Aydıner Elif, Boran Perran
Division of Pediatrics, Department of Social Pediatrics, Marmara University Faculty of Medicine, İstanbul, Turkey; Institute of Health Sciences, Marmara University, İstanbul, Turkey.
Department of Pediatric Infectious Diseases, Marmara University Faculty of Medicine, İstanbul, Turkey.
Turk Arch Pediatr. 2023 Sep;58(5):531-538. doi: 10.5152/TurkArchPediatr.2023.23097.
Despite marked improvements in the accessibility of childhood vaccines, knowledge gaps remain about the vaccination of children in special risk groups (SRG). This study aimed to analyze the clinical data of children vaccinated in SRG in a single-center unit to contribute to the clinical evidence for the specific planning of immunization of children in SRG. The second- ary aim is to present institutional consensus on the vaccination of children in SRG.
This retrospective study was conducted at a single-center pediatric vaccination clinic. Patient charts between 2018 and 2021 were retrospectively reviewed, and clinical and laboratory data were extracted. Serial joint meetings with multiple healthcare pro- fessionals were performed to develop an institutional protocol for vaccination.
There were 479 children vaccinated between 2018 and 2021 for reasons such as post- chemotherapy, after hematopoietic stem cell transplantation, before/after solid organ trans- plantation, allergies, and chronic diseases. Of these, 298 (62.2%) children vaccinated in the unit due to a history of food or vaccine allergies were excluded. One hundred eighty-one children were vaccinated at a median age of 11 [7-15] years. Most children were vaccinated after treat- ment for malignancies. Solid tumors were the most frequent malignancy (67%), followed by acute lymphoblastic leukemia (29.0%) and acute myeloid leukemia (4.0%). Institutional vacci- nation protocols for cancer survivors, hematopoietic stem cells, and solid organ recipient chil- dren were developed and presented.
There is a need to prepare national guidelines for vaccinating children with altered immunocompetence. Sharing vaccination practices by multidisciplinary vaccination units might increase and provide knowledge to develop national policies.
尽管儿童疫苗的可及性有了显著改善，但对于特殊风险群体（SRG）儿童的疫苗接种仍存在知识空白。本研究旨在分析单中心单位中SRG儿童的疫苗接种临床数据，为SRG儿童免疫规划的具体制定提供临床依据。次要目的是提出关于SRG儿童疫苗接种的机构共识。
本回顾性研究在单中心儿科疫苗接种诊所进行。回顾性查阅2018年至2021年期间的患者病历，并提取临床和实验室数据。与多名医疗保健专业人员召开系列联合会议，制定机构疫苗接种方案。
2018年至2021年期间，有479名儿童因化疗后、造血干细胞移植后、实体器官移植前后、过敏和慢性病等原因接种了疫苗。其中，因食物或疫苗过敏史在该单位接种疫苗的298名（62.2%）儿童被排除。181名儿童接种疫苗的中位年龄为11[范围7 - 15]岁。大多数儿童在恶性肿瘤治疗后接种疫苗。实体瘤是最常见的恶性肿瘤（67%），其次是急性淋巴细胞白血病（29.0%）和急性髓细胞白血病（4.0%）。制定并展示了针对癌症幸存者、造血干细胞和实体器官受者儿童的机构疫苗接种方案。
有必要制定针对免疫功能改变儿童的国家疫苗接种指南。多学科疫苗接种单位分享疫苗接种实践可能会增加并为制定国家政策提供知识。
