Sema Bozkaya-Yilmaz1, Eda Karadag-Oncel2, Nihal Olgac-Dundar3, Pinar Gencpinar4, Berrak Sarioglu5, Pinar Arican5, Atilla Ersen5, Dilek Yilmaz-Ciftdoğan6, Merve Feyza Yuksel7, Omer Bektas7, Serap Teber7, Betul Kilic8, Mustafa Calik9, Meryem Karaca10, Mehmet Canpolat11, Sefer Kumandas11, Huseyin Per11, Hakan Gumus11, Selcan Ozturk11, Cetin Okuyaz12, Mustafa Komur12, Rojan Ipek12, Pınar Ozbudak13, Ebru Arhan13, Hulya Ince14, Gurkan Gurbuz15, Gulen Gul Mert16, Neslihan Ozcan16, Akgun Olmez Turker17, Hande Gazeteci-Tekin18, Serkan Kırık19, Ceren Günbey20, Kürşat Bora Çarman21, Coşkun Yarar21, Dilek Çavuşoğlu22. 1. Department of Pediatric Neurology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey. semabozkayayilmaz@gmail.com. 2. Department of Pediatric Infectious Diseases, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey. 3. Department of Pediatric Neurology, Faculty of Medicine, Katip Çelebi University, Izmir, Turkey. nodundar@gmail.com. 4. Department of Pediatric Neurology, Faculty of Medicine, Katip Çelebi University, Izmir, Turkey. 5. Department of Pediatric Neurology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey. 6. Department of Pediatric Infectious Diseases, Faculty of Medicine, Katip Celebi University, Izmir, Turkey. 7. Department of Pediatric Neurology, Faculty of Medicine, Ankara University, Ankara, Turkey. 8. Department of Pediatric Neurology, Faculty of Medicine, Medipol University, Istanbul, Turkey. 9. Department of Pediatric Neurology, Faculty of Medicine, Harran University, Sanlıurfa, Turkey. 10. Department of Pediatric Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. 11. Department of Pediatric Neurology, Faculty of Medicine, Erciyes University, Kayseri, Turkey. 12. Department of Pediatric Neurology, Faculty of Medicine, Mersin University, Mersin, Turkey. 13. Department of Pediatric Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey. 14. Department of Pediatric Neurology, Samsun Medical Park Hospital, Samsun, Turkey. 15. Department of Pediatric Neurology, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey. 16. Department of Pediatric Neurology, Faculty of Medicine, Cukurova University, Adana, Turkey. 17. Department of Pediatric Neurology, Private Clinic, Denizli, Turkey. 18. Department of Pediatric Neurology, Faculty of Medicine, Bakircay University, Izmir, Turkey. 19. Department of Pediatric Neurology, Faculty of Medicine, Firat University, Elazig, Turkey. 20. Department of Pediatric Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. 21. Department of Pediatric Neurology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey. 22. Department of Pediatric Neurology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey.
Abstract
Children with chronic neurological diseases, including cerebral palsy (CP), are especially susceptible to vaccine-preventable infections and face an increased risk of severe respiratory infections and decompensation of their disease. This study aims to examine age-appropriate immunization status and related factors in the CP population of our country. This cross-sectional prospective multicentered survey study included 18 pediatric neurology clinics around Turkey, wherein outpatient children with CP were included in the study. Data on patient and CP characteristics, concomitant disorders, vaccination status included in the National Immunization Program (NIP), administration, and influenza vaccine recommendation were collected at a single visit. A total of 1194 patients were enrolled. Regarding immunization records, the most frequently administrated and schedule completed vaccines were BCG (90.8%), hepatitis B (88.9%), and oral poliovirus vaccine (88.5%). MMR was administered to 77.3%, and DTaP-IPV-HiB was administered to 60.5% of patients. For the pneumococcal vaccines, 54.1% of children received PCV in the scope of the NIP, and 15.2% of children were not fully vaccinated for their age. The influenza vaccine was administered only to 3.4% of the patients at any time and was never recommended to 1122 parents (93.9%). In the patients with severe (grades 4 and 5) motor dysfunction, the frequency of incomplete/none vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically more common than mild to moderate (grades 1-3) motor dysfunction (p = 0.003, p < 0.001, p < 0.001, p < 0.00, and p < 0.001, respectively). Physicians' influenza vaccine recommendation was higher in the severe motor dysfunction group, and the difference was statistically significant (p = 0.029). Conclusion: Children with CP had lower immunization rates and incomplete immunization programs. Clinicians must ensure children with CP receive the same preventative health measures as healthy children, including vaccines. What is Known: • Health authorities have defined chronic neurological diseases as high-risk conditions for influenza and pneumococcal infections, and they recommend vaccines against these infections. • Children with CP have a high risk of incomplete and delayed immunization, a significant concern given to their increased healthcare needs and vulnerability to infectious diseases. What is New: • Influenza vaccination was recommended for patients hospitalized due to pneumonia at a higher rate, and patients were administered influenza vaccine more commonly. • Children with CP who had higher levels of motor dysfunction (levels 4 and 5) were more likely to be overdue immunizations.
Children with chronic neurological diseases, including cerebral palsy (CP), are especially susceptible to vaccine-preventable infections and face an increased risk of severe respiratory infections and decompensation of their disease. This study aims to examine age-appropriate immunization status and related factors in the CP population of our country. This cross-sectional prospective multicentered survey study included 18 pediatric neurology clinics around Turkey, wherein outpatient children with CP were included in the study. Data on patient and CP characteristics, concomitant disorders, vaccination status included in the National Immunization Program (NIP), administration, and influenza vaccine recommendation were collected at a single visit. A total of 1194 patients were enrolled. Regarding immunization records, the most frequently administrated and schedule completed vaccines were BCG (90.8%), hepatitis B (88.9%), and oral poliovirus vaccine (88.5%). MMR was administered to 77.3%, and DTaP-IPV-HiB was administered to 60.5% of patients. For the pneumococcal vaccines, 54.1% of children received PCV in the scope of the NIP, and 15.2% of children were not fully vaccinated for their age. The influenza vaccine was administered only to 3.4% of the patients at any time and was never recommended to 1122 parents (93.9%). In the patients with severe (grades 4 and 5) motor dysfunction, the frequency of incomplete/none vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically more common than mild to moderate (grades 1-3) motor dysfunction (p = 0.003, p < 0.001, p < 0.001, p < 0.00, and p < 0.001, respectively). Physicians' influenza vaccine recommendation was higher in the severe motor dysfunction group, and the difference was statistically significant (p = 0.029). Conclusion: Children with CP had lower immunization rates and incomplete immunization programs. Clinicians must ensure children with CP receive the same preventative health measures as healthy children, including vaccines. What is Known: • Health authorities have defined chronic neurological diseases as high-risk conditions for influenza and pneumococcal infections, and they recommend vaccines against these infections. • Children with CP have a high risk of incomplete and delayed immunization, a significant concern given to their increased healthcare needs and vulnerability to infectious diseases. What is New: • Influenza vaccination was recommended for patients hospitalized due to pneumonia at a higher rate, and patients were administered influenza vaccine more commonly. • Children with CP who had higher levels of motor dysfunction (levels 4 and 5) were more likely to be overdue immunizations.