Influenza and pneumococcus vaccination rates in pediatric dialysis patients in Europe: recommendations vs reality A European Pediatric Dialysis Working Group and European Society for Pediatric Nephrology Dialysis Working Group study


Journal

Turkish journal of medical sciences
ISSN: 1303-6165
Titre abrégé: Turk J Med Sci
Pays: Turkey
ID NLM: 9441758

Informations de publication

Date de publication:
13 12 2021
Historique:
received: 03 12 2020
accepted: 03 02 2021
entrez: 4 2 2021
pubmed: 5 2 2021
medline: 28 12 2021
Statut: epublish

Résumé

Children on dialysis are under increased risk of influenza and invasive pneumococcal disease. Although vaccination against these microorganisms are recommended in dialysis patients and despite the fact that these vaccines can reduce disease burden and rates of hospitalization due to infection, vaccination rates are below expected and desired. We aimed to evaluate influenza and pneumococcal vaccination and infection rates in European pediatric dialysis centers. In 16 centers from 11 countries, 357 pediatric dialysis patients were evaluated retrospectively during 1 year of observation period between 01.01.2014 and 01.01.2015. In all centers, vaccination policy included immunization of dialysis patients with inactive influenza vaccine and pneumococcal conjugate vaccine (PCV). Fifty percent of the centers recommended pneumococcal polysaccharide vaccine following routine PCV series. A significantly higher pneumococcal vaccination rate (43.9%) was seen in peritoneal dialysis (PD) patients compared to those on hemodialysis (HD) (32.9%) (p = 0.035), while the rates for influenza were similar (42.4% and 46.1% respectively, p = 0.496). Among all dialysis patients, 2.2% (n = 8) developed pneumonia and 6.4% (n = 23) was infected by Influenza. Pneumococcic pneumonia rate was 5% for 140 patients who received antipneumococcal vaccine, while only one pneumonia episode was recorded out of 217 unvaccinated patients (p = 0.007). The influenza virus infection rates were similar for patients vaccinated and nonvaccinated (7 % and 6 %, respectively). Although influenza and pneumococcal vaccines are highly recommended in pediatric dialysis patients, vaccination rates were lower than expected. Pneumococcal vaccination rates were higher in PD compared to the patients on HD. The rate of children with influenza infection was higher than pneumonia. The efficacy of influenza and pneumococcal vaccines was highlighted by the low infection rates. Higher pneumonia rates in patients vaccinated against pneumococcus compared to unvaccinated ones might be due to coexisting risk factors.

Sections du résumé

Background/aim
Children on dialysis are under increased risk of influenza and invasive pneumococcal disease. Although vaccination against these microorganisms are recommended in dialysis patients and despite the fact that these vaccines can reduce disease burden and rates of hospitalization due to infection, vaccination rates are below expected and desired. We aimed to evaluate influenza and pneumococcal vaccination and infection rates in European pediatric dialysis centers.
Materials and methods
In 16 centers from 11 countries, 357 pediatric dialysis patients were evaluated retrospectively during 1 year of observation period between 01.01.2014 and 01.01.2015.
Results
In all centers, vaccination policy included immunization of dialysis patients with inactive influenza vaccine and pneumococcal conjugate vaccine (PCV). Fifty percent of the centers recommended pneumococcal polysaccharide vaccine following routine PCV series. A significantly higher pneumococcal vaccination rate (43.9%) was seen in peritoneal dialysis (PD) patients compared to those on hemodialysis (HD) (32.9%) (p = 0.035), while the rates for influenza were similar (42.4% and 46.1% respectively, p = 0.496). Among all dialysis patients, 2.2% (n = 8) developed pneumonia and 6.4% (n = 23) was infected by Influenza. Pneumococcic pneumonia rate was 5% for 140 patients who received antipneumococcal vaccine, while only one pneumonia episode was recorded out of 217 unvaccinated patients (p = 0.007). The influenza virus infection rates were similar for patients vaccinated and nonvaccinated (7 % and 6 %, respectively).
Conclusions
Although influenza and pneumococcal vaccines are highly recommended in pediatric dialysis patients, vaccination rates were lower than expected. Pneumococcal vaccination rates were higher in PD compared to the patients on HD. The rate of children with influenza infection was higher than pneumonia. The efficacy of influenza and pneumococcal vaccines was highlighted by the low infection rates. Higher pneumonia rates in patients vaccinated against pneumococcus compared to unvaccinated ones might be due to coexisting risk factors.

Identifiants

pubmed: 33535736
doi: 10.3906/sag-2012-26
doi:

Substances chimiques

Antibodies 0
Influenza Vaccines 0
Pneumococcal Vaccines 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2881-2886

Informations de copyright

The authors declare that there are no competing conflicts of interest.

Auteurs

Yeşim Özdemir Atikel (YÖ)

Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey

Sevcan A Bakkaloğlu (SA)

Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey

Fabio Paglialonga (F)

Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Constantinos J Stefanidis (CJ)

Department of Pediatric Nephrology, Mitera Children’s Hospital, Athens, Greece

Varvara Askiti (V)

Department of Pediatric Nephrology, A. and P. Kyriakou Children’s Hospital, Athens, Greece

Enrico Vidal (E)

Department of Pediatric Nephrology, Faculty of Medicine, Padova University, Padova, Italy

Gema Ariceta (G)

Department of Pediatric Nephrology, University Hospital Vall d’ Hebron, Barcelona, Spain

Engin Melek (E)

Department of Pediatric Nephrology, Faculty of Medicine, Çukurova University, Adana, Turkey

Enrico Verrina (E)

Dialysis Unit, Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genoa, Italy

Nikoleta Printza (N)

1st Pediatric Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece

Karel Vondrak (K)

Department of Pediatric Nephrology, Faculty of Medicine, University Hospital Motol, Prague, Czech Republic

Aleksandra Zurowska (A)

Department of Pediatrics Nephrology & Hypertension, Medical University of Gdansk, Gdansk, Poland

Ilona Zagozdzon (I)

Department of Pediatrics Nephrology & Hypertension, Medical University of Gdansk, Gdansk, Poland

Mesiha Ekim (M)

Department of Pediatric Nephrology, Faculty of Medicine, Ankara University, Ankara, Turkey

Elif Nursel Özmert (EN)

Department of Social Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey

Stephanie Dufek (S)

Department of Pediatric Nephrology, Great Ormond Street Hospital for Children, London, UK

Augustina Jankauskiene (A)

Pediatric Center, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania

Claus Peter Schmitt (CP)

Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany

Eszter Levai (E)

Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany

Johan Vande Walle (JV)

Department of Pediatric Nephrology, Utoped, Universitair Ziekenhuis Gent, Ghent, Belgium

Nur Canpolat (N)

Department of Pediatric Nephrology, Cerrahpaşa Medical School, İstanbul, Turkey

Tuula Holtta (T)

Department of Pediatric Nephrology, Faculty of Medicine, University of Helsinki, Helsinki, Finland

Michel Fischbach (M)

Department of Pediatric Nephrology, Hopital de Hautepierre, Strasbourg, France

Ariane Zaloszyc (A)

Department of Pediatric Nephrology, Hopital de Hautepierre, Strasbourg, France

Guenter Klaus (G)

Department of Pediatric Nephrology, KfH Children’s Kidney Center, Marburg, Germany

Christoph Aufricht (C)

Department of Pediatric Nephrology, Medical University of Vienna, Vienna, Austria

Rukshana Shroff (R)

Department of Pediatric Nephrology, Great Ormond Street Hospital for Children, London, UK

Alberto Edefonti (A)

Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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