Abstract
Context
Vaccine preventable diseases lead to distressful symptoms and complications among
pediatric patients receiving specialized home palliative care. There was no data on
the vaccination compliance.
Objective
The objective was to determine the vaccination coverage, discuss the relevance of
vaccinations and provide vaccination recommendations in pediatric palliative care.
Methods
Vaccination data were compared in a multicenter cross-sectional study. Expert interviews
were conducted to evaluate symptom burden. The vaccination status of patients treated
by six German pediatric specialized home palliative care teams was recorded from 01/2019
to 12/2019. The data were compared to the national immunization schedule and the vaccination
rate of a representative German pediatric cohort. Onset of missed vaccination was
compared to the date of diagnosis of the life-limiting condition. A risk score was
calculated to evaluate the relevance of each individual vaccinations.
Results
Vaccination rates of Tdpa, haemophilus influenzae type B, poliomyelitis, hepatitis
B, pneumococcal disease, meningococcal diseases type C, and MMR were lower compared
to healthy controls. There were no significant differences in varicella. In most cases
the discontinuation of recommended immunizations occurred after diagnosis of the palliative
condition. Influenza had the highest risk score and was the most frequent vaccine
preventable disease in retrospective data. This paper includes a pragmatic proposal
for the management of vaccination in this vulnerable population.
Conclusion
Children and adolescents with life-limiting conditions are at increased risk of vaccine
preventable diseases. Individual vaccination counselling is recommended.
Key Words
Abbreviations:
HepB (hepatitis B), HiB (haemophilus influenzae type b), HPV (human papillomavirus), ICD (International Classification of Diseases), KiGGS (Study on the Health of Children and Adolescents in Germany), MMR (measles, mumps, and rubella), RSV (respiratory syncytial virus), Tdap (tetanus, diphtheria, and pertussis), WHO (World Health Organization)To read this article in full you will need to make a payment
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Article Info
Publication History
Accepted:
October 25,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine.
