Harris Julia G, Favier Leslie, Jones Jordan T, Ibarra Maria, Holland Michael J, Fox Emily, Jensen Kelly, Sherman Ashley K, Cooper Ashley M
Department of Pediatrics, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
Pediatr Rheumatol Online J. 2024 Dec 18;22(1):104. doi: 10.1186/s12969-024-01048-1.
Most patients with a pediatric rheumatic disease are at increased risk of influenza due to immunosuppressive medication use. Despite initial quality improvement efforts, our influenza vaccination rate plateaued at 72%, which prompted a survey of patients and families to assess provider vaccine recommendations, influenza knowledge, and barriers to influenza vaccination.
Patients on immunosuppressive medication or their parent were eligible to complete a survey between July 2019 and January 2020. Survey questions assessed demographics, rheumatology diagnosis, immunosuppressive medication(s), influenza vaccination recommendation, patient/parent influenza knowledge, and barriers to influenza vaccination. Influenza vaccination rates for immunosuppressed patients were acquired each influenza season from 2015-2020 and tracked on a control chart.
Of the 226 completed surveys, 145 (64.2%) were completed by parents and 81 (35.8%) by patients. The majority (85%) reported the influenza vaccine was recommended. The most common reasons for not receiving the influenza vaccine included: worry about disease flare (25.6%), concern the vaccine will cause influenza (25.6%), and lack of vaccine effectiveness (20.5%). Parents (40.9%) were more worried about disease flare compared to patients (17%; p = 0.024). Most respondents were able to correctly answer fever, cough and/or congestion as the most common symptoms of influenza; however, 23% answered gastrointestinal symptoms and 10.2% joint swelling. Most respondents (95.1%) were aware that immunosuppressive medication increases risk of infection. The average weekly influenza vaccination rate for the 2019-2020 flu season was 85.5%, which increased from 72.0% the previous year. Parents with higher education status were more likely to have their child receive the influenza vaccine compared to parents with less education.
This survey indicates that respondents understand the potential severity of influenza and the increased risk of infection due to immunosuppressive medication use; however, many inaccurately identified the most common symptoms of influenza and also reported misconceptions of influenza vaccine risks. The barriers identified in this survey will help drive future improvement efforts to increase influenza vaccination rates in this high-risk population.
大多数患有儿科风湿性疾病的患者因使用免疫抑制药物而患流感的风险增加。尽管最初进行了质量改进工作，但我们的流感疫苗接种率稳定在72%，这促使我们对患者及其家属进行了一项调查，以评估医生的疫苗建议、流感知识以及流感疫苗接种的障碍。
2019年7月至2020年1月期间，正在使用免疫抑制药物的患者或其父母有资格完成一项调查。调查问题评估了人口统计学、风湿病诊断、免疫抑制药物、流感疫苗接种建议、患者/父母的流感知识以及流感疫苗接种的障碍。2015 - 2020年每个流感季节获取免疫抑制患者的流感疫苗接种率，并在控制图上进行跟踪。
在226份完成的调查问卷中，145份（64.2%）由父母完成，81份（35.8%）由患者完成。大多数（85%）报告称流感疫苗是被推荐的。未接种流感疫苗的最常见原因包括：担心疾病复发（25.6%）、担心疫苗会导致流感（25.6%）以及认为疫苗无效（20.5%）。与患者（17%）相比，父母（40.9%）更担心疾病复发（p = 0.024）。大多数受访者能够正确回答发热、咳嗽和/或鼻塞是流感最常见的症状；然而，23%的人回答是胃肠道症状，10.2%的人回答是关节肿胀。大多数受访者（95.1%）意识到免疫抑制药物会增加感染风险。2019 - 2020流感季节的平均每周流感疫苗接种率为85.5%，高于上一年的72.0%。与受教育程度较低的父母相比，受教育程度较高的父母更有可能让孩子接种流感疫苗。
这项调查表明，受访者了解流感的潜在严重性以及使用免疫抑制药物导致感染风险增加的情况；然而，许多人错误地识别了流感最常见的症状，并且还报告了对流感疫苗风险的误解。本次调查中确定的障碍将有助于推动未来的改进工作，以提高这一高危人群的流感疫苗接种率。
