Seasonal influenza vaccination in chronically ill children : the experience of a tertiary healthcare center

Abstract

Kronik hastalığı olan çocuklarda mevsimsel influenza aşılaması :bir üçüncü basamak sağlık merkezi deneyimi ÖZET Amaç: Kronik hastalığı olan çocuklarda mevsimsel influenza aşılaması önemlidir. Bununla birlikte, bu grupta aşılanma oranı olması gerekenin altındadır ve halk sağlığı hedefinden uzaktır. Bu çalışmanın amacı; kronik hastalığı olan çocukların mevsimsel influenza aşılaması ihtiyaçlarının merkezimizde daha yüksek oranda karşılanabilmesine yönelik çalışmalara katkı sağlamaktır. Gereç ve Yöntem: Bu çalışma Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesi'nde yapılmıştır ve tek merkezli, retrospektif bir çalışmadır. Çalışma Ekim 2015 ile Mayıs 2018 tarihleri arasındaki ardışık 3 influenza sezonunu kapsamaktadır. Bulgular: Ardışık 3 influenza sezonunda 315 kronik hastalığı olan çocuğa mevsimsel influenza aşısı uygulandı. Hastanemize 1 Ekim 2015 ve 31 Mayıs 2018 tarihleri arasındaki üç sezonda, aşı uygulanan çocuklarla aynı tanılardaki 12.690 kronik hasta çocuk kabul edilmiştir. Bu 315 çocuğun %87'si Astım, %4.4'ü Selektif IgA eksikliği, %2.2'si Nefrotik Sendrom, %1.6'sı Diyabetes Mellitus, %1.3'ü Kistik Fibrozis, %1.3'ü Hematopoetik Kök Hücre Nakli yapılan hasta, %0.96'sı Serebral Palsi hastası, %0.64'ü Duchenne Müsküler Distrofi hastası ve %0.6'sı Akut Lenfoblastik Lösemi hastasıdır. Sonuç: Bu çalışmada; kronik hastalıklı çocukların mevsimsel influenza aşılama oranları bu 3 influenza sezonunda giderek artmıştır. Ancak sayı halen düşüktür. Merkezimizde bu hasta grubunun aşılama oranlarını artıracak planlar yapmamız gerektiği açıktır. Anahtar kelimeler: aşılama, çocuk, influenza, kronik hastalık Seasonal influenza vaccination in chronically ill children : the experience of a tertiary healthcare center. ABSTRACT Objective: Seasonal influenza vaccination is important in children with chronic disease. However, the vaccination rate in this group is sub-optimal and far from the public health goal. The aim of this study is to contribute to research addressing the need for a higher rate of seasonal influenza vaccination of chronically ill children at our center. Material and Methods: This study was conducted in Ankara Child Health and Diseases, Hematology Oncology Training and Research Hospital and is a single-center retrospective study. The study covers 3 consecutive flu seasons between October 2015 and May 2018. Results: Seasonal influenza vaccine was administered to 315 chronically ill children in 3 consecutive flu seasons. During three seasons between October 1, 2015 and May 31, 2018, 12,690 chronically ill children were admitted to our center in the same diagnoses as children who were vaccinated. Of these 315 children, 87.0% had asthma, 4.4% had selective deficiency of immunoglobulin A, 2.2% had nephrotic syndrome, 1.6% had diabetes mellitus, 1.3% had cystic fibrosis, 1.3% were hematopoietic stem cell transplantation patients, 0.96% had cerebral palsy, 0.64% had Duchenne muscular dystrophy, and 0.6% had acute lymphoblastic leukemia. Conclusion: In this study, seasonal influenza vaccination rates of chronically ill children increased gradually in these 3 influenza seasons. However, the number is still low. It is clear that we need to plan to increase the vaccination rates of this patient group at our center. Keywords: Influenza, vaccination, child, chronic illness

Keywords

• Influenza,vaccination,child

References

1. Referans1. Guidance on the use of oseltamivir and amantadine for the prophylaxis of influenza. Technology Appraisal No. 67. National Institute for Clinical Excellence London; 2003. Available from:URL: www.nice.org.uk. Accessed17 February 2020.
2. Referans2. Jordan R, Connock M, Albon E, Fry-Smith A, Olowokure B, Hawker J, et al. Universal vaccination of children against influenza: are there indirect benefits to the community? A systematic review of the evidence. Vaccine 2006; 24:1047.
3. Referans3. Uchida M, Kaneko M, Hidaka Y, Yamamoto H, Honda T, Takeuchi T, et al. High vaccination coverage is associated with low epidemic level of seasonal influenza in elementary schools: an observational study in Matsumoto City, Japan. BMC Infect Dis. 2018;18:128.
4. Referans 4. Committee on Infectious diseases. Recommendations for Prevention and Control of Influenza in Children, 2017 - 2018. Pediatrics 2017; 140.
5. Referans5. Centers for Disease Control and Prevention. People at high risk of developing flu-related complications. Available from: URL:www.cdc.gov/flu/about/disease/high_risk.html. Accessed 17 February 2020
6. Referans6. Daley MF, Beaty BL, Barrow J, Pearson K, Crane LA, Berman S, et al. Missed opportunities for influenza vaccination in children with chronic medical conditions. Arch Pediatr Adolesc Med 2005;159:986-91.
7. Referans7. World Health Organization (WHO). Accessed 2 March 2020. Available from: https://www.who.int/classifications/icd/icdonlineversions/en/.
8. Referans8. American Academy of Pediatrics. Immunization in special clinical circumstances. In: Pickering L, Baker C, Kimberlin D, Long S (eds). Red Book: 2009 Report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009. Accessed 10 September 2019

9. Referans9. Centers for Disease Control and Prevention (CDC). Accessed 4 February 2020. Available from: https://www.cdc.gov/vaccines/hcp/aciprecs/generalrecs/immunocompetence. html.
10. Referans10. Avalible from:www.solunum.org.tr /TusadData/userfiles/file/3_UlusalAsiCalistayiRaporu. Accessed 8 January 2020.
11. Referans11.Resmi Gazete. Accessed 16 September 2019. Available from: http://www.resmigazete.gov.tr/eskiler/2016/11/20161126-13.html.
12. Referans12. O'Brien MA, Uyeki TM, Shay DK, Thompson WW, Kleinman K, McAdam A, et al. Incidence of outpatient visits and hospitalizations related to influenza in infants and young children. Pediatrics 2004;113:585-593.
13. Referans13. Launes C, García-García JJ, Martínez-Planas A et al. CIBERESP Cases and Controls in Pandemic Influenza WorkingGroup.Clinical features of influenza disease in admitted children duringthe first postpandemic season and risk factors for hospitalization:a multicentre Spanish experience. Clin Microbiol Infect. 2013;19:157-162.
14. Referans14. Rodríguez-Rieiro C, Domínguez-Berjón MF, Esteban-Vasallo MD, Sánchez-Perruca L, Astray-Mochales J, Fornies DI, et al. Vaccination coverage against 2009 seasonal influenza in chronically ill children and adults: analysis of population registries in primary care in Madrid (Spain). Vaccine 2010;28:6203-9.
15. Referans15. Dinleyici M, Carman KB, Kilic O, Laciner Gurlevik S, Yarar C, Dinleyici EC. The immunization status of children with chronic neurological disease and serological assessment of vaccine-preventable diseases. Hum Vaccin Immunother. 2018;14:1970-1976.
16. Referans16. Adadan Güvenç I, Parıldar H, Şahin MK, Erbek SS. Better knowledge and regular vaccination practices correlate well with higher seasonal influenza vaccine uptake in people at risk: Promising survey results from a university outpatient clinic. J Infect Control. 2017;45:740-745.
17. Referans17. Çelebi Sözener Z, Mısırlıgil M, Çerçi P, Aydın Ö, Kendirlinan R, Sin B ve ark. Attitudes of adult asthma patients towards influenza vaccination. Tüberküloz ve Toraks. 2016;64:269-274.
18. Referans18. Van Essen GA, Kuyvenhoven MN, de Melker RA. Compliance with influenza vaccination: its relation with epidemiologic and sociopsychological factors. Arch Fam Med. 1997;6:157–162.
19. Referans19. Christian MA. Influenza and hepatitis B vaccine acceptance: a survey of health care workers. Am J Infect Control 1991;19:177.
20. Referans20. Steingart KR, Thomas AR, Dykewicz CA, Redd SC. Transmission of measles virus in healthcare settings during a communitywide outbreak. Infect Control Hosp Epidemiol 1999; 20:115..
21. Referans21. Tielsch GA, Borkowski V, Konesky A, Bennhoff A. Taking Action on Asthma: Increasing Influenza Vaccination Rates in Pediatric Asthma Through Quality Improvement. J Pediatr Health Care. 2019;33:653-662.
22. Referans22. Livni G, Wainstein A, Birk E, Chodick G, Levy I. Influenza Vaccination Rate and Reasons for Nonvaccination in Children With Cardiac Disease. Pediatr Infect Dis J. 2017;36:268-271.
23. Referans23. Alkan A, Karcı E, Yaşar A, Tuncay G, Köksoy EB, Ürün M, et al. Vaccination in oncology practice and predictors. Support Care Cancer. 2017;25:2677-2682.
24. Referans24. Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, Brenner H, et al. Global Burden of Disease Cancer Collaboration. et al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2017;3:524-548.
25. Referans25. Nasi M, De Biasi S, Gibellini L, Bianchini E, Pecorini S, Bacca V, et al. Ageing and inflammation in patients with HIV infection. Clin Exp Immunol. 2017;187:44-52.
26. Referans26. Pandolfi E, Marino MG, Carloni E, Romano M, Gesualdo F, Borgia P, et al. The effect of physician's recommendation on seasonal influenza immunization in children with chronic diseases. BMC Public Health 2012;12:984.
27. Referans27. Briss PA, Rodewald LE, Hinman AR, Shefer AM, Strikas RA, Bernier RR, et al. Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. Am J Prev Med 2000;18:97-140.
28. Referans28. Bhat-Schelbert K, Lin CJ, Matambanadzo A, Hannibal K, Nowalk MP, Zimmerman RK. Barriers to and facilitators of child influenza vaccine - Perspectives from parents, teens, marketing and healthcare professionals. Vaccine 2012; 30:2448-52.
29. Referans29. Lane NE, Paul RI, Bratcher DF, Stover BH. A survey of policies at children's hospitals regarding immunity of healthcare workers: are physicians protected? Infect Control Hosp Epidemiol 1997;18:400.