VACCINATION COVERAGE IN CHILDREN WITH RHEUMATIC AND IMMUNE-MEDIATED INFLAMMATORY DISEASES: A RETROSPECTIVE COHORT STUDY

Résumé fourni par la source

Children with immune-mediated inflammatory diseases receiving immunosuppressive therapy are at increased risk of vaccine-preventable infections. Despite the availability of international recommendations on vaccination for this patient population, data on real-world immunization coverage in the Russian pediatric population are limited. Objective: To assess vaccination coverage in children (0–17 years inclusive) with rheumatic and immune-mediated inflammatory diseases before and after diagnosis, and to identify factors associated with immunization coverage. Materials and Methods: A single-center retrospective cohort study was conducted, including 336 patients with autoimmune diseases. Results: The study included children aged 0 to 17 years, with a median age of 14.1 years [11.1; 16.4]. Females predominated: 203/336 (60.4%) vs 133/336 (39.6%). Coverage with basic vaccines ranged from 82% to 87%: DTP components – pertussis 84.2% (95% CI 79.9–87.8), diphtheria 87.2% (83.2–90.4), tetanus 85.1% (80.9–88.5); polio – 83.9% (79.6–87.5); measles, rubella, mumps – 81.2% (76.7–85.1); BCG – 81.5% (77.1–85.3); hepatitis B – 82.4% (78.0–86.1). In contrast, vaccination coverage against respiratory pathogens remained low: pneumococcal infection – 23.5% (19.3–28.3), influenza – 20.2% (16.3–24.9). Therapy with biologic disease-modifying antirheumatic drugs (bDMARDs) showed no statistically significant association with influenza vaccination after the onset of immune-mediated inflammatory disease (OR 0.53; 95% CI 0.20–1.42; p=0.208). Conclusion: High coverage with basic National Immunization Schedule vaccines (81–87%) was found, with a substantial lag in coverage for vaccines most important for patients with potential immunosuppression. These findings support the integration of preventive vaccination into the standard patient pathway for immune-mediated inflammatory diseases, with a clear distribution of responsibility among specialists and regular verification of vaccination status.

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