Vaccination in at-risk children: too much may be harmful
Antonietta Giannattasio, MD, PhD; Andrea Lo Vecchio, MD; Alfredo
Guarino, Full Professor of Paediatrics.
According to the European Centre for Disease Control and Prevention,
strategies are needed at national and regional levels, to indicate who
should be offered the new influenza vaccine, how to prioritise target
populations, and what are the pathways to ensure rapid vaccination in
large cohort of subjects.(1)
Vaccination of at-risk children requires three actions: proper
information to the families, vaccine administration and routine check of
immunization. Any of the three actions may be carried on in any of the
following settings: family practitioners’ office, reference centres for
the chronic condition and vaccination centres. Proper information and
organization are essential for effective immunization strategies.
We obtained data in 343 children with at-risk condition (HIV
infection, cystic fibrosis, type 1 diabetes, liver transplantation)
showing very low (less than 25% in each group) pneumococcal vaccination
rate. Approximately 60% of at-risk children were vaccinated against
influenza. The lowest rate for either vaccination were observed in
diabetic children. Interestingly, physicians in the reference centres had
a major role in recommending vaccination to children with HIV infection,
liver transplantation and cystic fibrosis, whereas primary care
paediatricians had a main role with diabetic patients. A barrier to
vaccination included the lack of awareness of specific risk linked to
chronic conditions by parents of children. However, the major problem was
redundancy of roles of different physicians in charge of at-risk children
and, more specifically, the lack of identification of who was responsible
for vaccination.
To ensure an effective vaccination policy in at-risk children, three
order of actions should be rapidly applied in order to achieve an optimal
vaccination coverage: clear information to families on where to go to
receive vaccination; coordination among the physicians involved in the
care of children to avoid redundancy; control of immunization performed
routinely and in exceptional circumstances.
References
1. European Centre for Disease Prevention and Control. Use of
specific pandemic influenza vaccines during the H1N1 2009 pandemic.
Aavailable at:
Rapid Response:
Vaccination in at-risk children: too much may be harmful
Antonietta Giannattasio, MD, PhD; Andrea Lo Vecchio, MD; Alfredo
Guarino, Full Professor of Paediatrics.
According to the European Centre for Disease Control and Prevention,
strategies are needed at national and regional levels, to indicate who
should be offered the new influenza vaccine, how to prioritise target
populations, and what are the pathways to ensure rapid vaccination in
large cohort of subjects.(1)
Vaccination of at-risk children requires three actions: proper
information to the families, vaccine administration and routine check of
immunization. Any of the three actions may be carried on in any of the
following settings: family practitioners’ office, reference centres for
the chronic condition and vaccination centres. Proper information and
organization are essential for effective immunization strategies.
We obtained data in 343 children with at-risk condition (HIV
infection, cystic fibrosis, type 1 diabetes, liver transplantation)
showing very low (less than 25% in each group) pneumococcal vaccination
rate. Approximately 60% of at-risk children were vaccinated against
influenza. The lowest rate for either vaccination were observed in
diabetic children. Interestingly, physicians in the reference centres had
a major role in recommending vaccination to children with HIV infection,
liver transplantation and cystic fibrosis, whereas primary care
paediatricians had a main role with diabetic patients. A barrier to
vaccination included the lack of awareness of specific risk linked to
chronic conditions by parents of children. However, the major problem was
redundancy of roles of different physicians in charge of at-risk children
and, more specifically, the lack of identification of who was responsible
for vaccination.
To ensure an effective vaccination policy in at-risk children, three
order of actions should be rapidly applied in order to achieve an optimal
vaccination coverage: clear information to families on where to go to
receive vaccination; coordination among the physicians involved in the
care of children to avoid redundancy; control of immunization performed
routinely and in exceptional circumstances.
References
1. European Centre for Disease Prevention and Control. Use of
specific pandemic influenza vaccines during the H1N1 2009 pandemic.
Aavailable at:
http://www.ecdc.europa.eu/en/publications/Publications/0908_GUI_Pandemic...
Competing interests:
None declared
Competing interests: No competing interests