HIV-infected children vaccination coverage and safety in a Western European cohort: a retrospective study

Abstract

Since the implementation of highly active antiretroviral therapy in HIV-infected children, response to scheduled vaccines may determinate future morbidity and mortality. The aims of this study have been to describe the current vaccine coverage, vaccine safety and concordance with vaccine recommendations of the 68 HIV-infected children and adolescents followed up in our Unit. Forty-four percent of the children received at least one dose of the oral polio vaccine (OPV). Only 9.1% needed and received a second set of hepatitis B virus immunization because of low vaccine response. Only 14.7% were vaccinated against varicella. Coverages of 82.3% and 100% have been reached with the 23-valent and the 7-valent pneumococcal vaccines, respectively. Meningococcal conjugated vaccine uptake was moderate (80.8%). Influenza annual vaccination coverage was poor: only 22.7% had well-documented yearly vaccines. In our experience, vaccine coverage is lower in those vaccines administered in primary care centres compared with the immunizations given at the hospital. OPV administration did not cause any adverse effect in the children or in their families. Vaccine coverage in HIV-infected children was suboptimal.

Predictors for and coverage of influenza vaccination among HIV‐positive patients: a cross‐sectional survey

“…In France, two single‐centre studies reported vaccination rates of 21% and 31% among adult HIV‐positive patients. Another study from Spain focusing on HIV‐infected children reported that only 23% had a yearly influenza vaccination documented . Based on the available data, it appears that influenza vaccination rates among HIV‐positive patients in Europe are lower than in the USA.…”

Undervaccination of Perinatally HIV-infected and HIV-exposed Uninfected Children in Latin America and the Caribbean

“…However, health care staff responsible for immunization delivery may miss opportunities for immunizing HIV-infected children because they are unaware of those recommendations, they are concerned about greater risk with use of vaccines in this population, or other reasons. African [4, 5] and European studies [6,7, 8] found lower immunization coverage of HIV-infected children compared to uninfected peers, while a North American study found equally low vaccine coverage, for both HIV-infected and the HIV-exposed uninfected populations for some vaccines [9]. In a rural South African population, maternal HIV-positive status was independently associated with lower vaccination rates for four vaccines in children 12–23 month of age (BCG, DTP3, poliomyelitis, and hepatitis B) [10].…”

Seroprevalence and vaccination coverage of vaccine-preventable diseases in perinatally HIV-1-infected patients

“…17 Despite HIV infected children are prone to infectious diseases and the protection of such vulnerable population should be undertaken, immunization reluctance is a widely phenomenon described also in other European studies. [10][11][12] This is partially due to the concerns regarding safety of vaccines, 18,19 especially with live-attenuated vaccines, in severely immunocompromised individuals. Moreover, the increase of HIV viral load after vaccination, as result of T-cell activation and proliferation, therefore disease progression, represents reason of hesitancy.…”

“…[5][6][7][8][9] Although these children represent an appropriate target group for immunization, the available data indicate suboptimal coverage rates, partially due to the physician uncertainty regarding the time-course of the immune reconstitution, the optimal timing of vaccination after starting HAART, and the safety profile in such patients. 5,[10][11][12] Moreover, for HIV-infected individuals, appropriate strategies are crucial for identifying those susceptible to preventable infections and prone to severe complications, and for ensuring them adequate protective immunity through the specific immunization schedules in terms of timing and number of vaccine doses rather than undergoing revaccination upon failure of immunization. 13 Background.…”