Session Type: Abstract Submissions (ACR)
To determine the vaccination status of children with rheumatic diseases, and identify immunization knowledge of families and potential barriers to vaccination.
A cross-sectional study of children with rheumatic diseases followed at a tertiary care center outpatient clinic was performed between October 2013 and March 2014. Demographics, diagnosis and current treatments were obtained from health records. Children were considered immunosuppressed, if they were currently received corticosteroids, non-biologic or biologic disease-modifying agents. A unique provincial electronic database that records accurate vaccine history was used to obtain actual patient vaccination history. Perceived immunization barriers, concerns and knowledge regarding contraindications to vaccination, and sources of immunization information were captured from a patient/parent questionnaire. Descriptive statistical methods were used to analyze the data.
A total of 82 children were recruited into the study. The median age was 11.7 years. The most common diagnoses were juvenile idiopathic arthritis (65%), systemic lupus erythematosus (9%), and juvenile dermatomyositis (5%). Fifty eight (71%) children were considered immunosuppressed.
Vaccination database: Patients received most recommended vaccines, with the exception of the Influenza (2013/2014) and Hepatitis B vaccines (recommended for age of 10 [grade 5] in Canada). Influenza was missed 40% of the time in the 1 – 3 years old group, 18% of the time in the 4 – 9 years old group, and 27% of the time in the 10 – 17 years old group. Hepatitis B was missed at a rate of 4% in the 10 – 17 years old group.
Patient/parent questionnaire: Nine patients reported previous adverse reactions to vaccination (Influenza , Measles, Mumps, and Rubella (MMR) , Hepatitis B  and Varicella ). In 38% at least one vaccination was withheld, most commonly for active disease (26%), recommendation against receiving vaccinations by health care provider (23%), uncertainty about whether or not a vaccine should be given (19%), concerns about disease flare (13%) and/or side effects post vaccination (5%). Several sources of information were utilized by patients and families for vaccination information, and satisfaction with this information was fairly high. Patients and parents identified the following information gaps: 1) risks and contraindications of vaccinations in childhood rheumatic diseases, 2) age-appropriate vaccination schedules and modalities, 3) best practice of vaccination documentation. Vaccination reminders were identified as useful, with several comments indicating that e-mail alerts, reminders, and a method to track this information would be useful.
The majority of children with rheumatic illnesses received the recommended vaccines. Immunization gaps were identified for Influenza and Hepatitis B. Knowledge regarding contraindications to vaccination is good. Concerns about perceived safety limit vaccination completeness.
« Back to 2014 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/immunization-status-and-barriers-in-childhood-rheumatic-diseases/