Vaccination recommendations, immunization status and safety of vaccination for premature infants in Zhejiang, China

Evaluation of vaccination status of children with special health care needs in Suzhou, China, 2020-2022: A retrospective survey study

Children with special health care needs (CSHCNs) are at an increased risk of vaccine-preventable infections (VPDs), but they also face the dilemma of vaccine hesitancy. We obtained information on pediatric visits from the Referral and Assessment Information System for Vaccination (RAISV) and information on vaccination from the Jiangsu Province Immunization Information System (JSIIS). We followed the occurrence of Adverse Events Following Immunization (AEFIs) and VPDs by actively calling and querying the China Information System for Disease Control and Prevention (CISDCP). The Poisson test was used to compare the incidence of AEFIs between groups. A total of 5,037 children who visited a vaccination assessment clinic were followed-up in this study. The majority were children with developmental anomalies (28.5%), certain conditions originating in the perinatal period (12.1%), and nervous system disorders (9.0%). Most CSHCNs (66.9%) were advised to have all vaccines according to routine practice, 29.0% were advised to have partial vaccination, and 4.1% were advised to delay all vaccines and wait for future assessment. A total of 201 (4.0%) CSHCNs were not vaccinated, although they were assessed to be eligible for vaccination. By querying the immunization planning module in CISDCP, we observed 55 AEFI cases, which amounted to an incidence rate of 1.2 per 1,000, and the occurrence of abnormal reactions was not significantly different compared with the general population. The vaccination program following the designed workflow for CSHCNs was safe and could be recommended in other areas.

Vaccination coverage and immunization safety among children with special health status in Chongqing, China

Vaccination of children with special health status has become one of the most urgent issues in China. We aim to evaluate vaccination coverage and safety as well as its associated factors among children with special health status in China during 2016‒2020. We conducted a retrospective cohort review of all children with special health status recorded in the Electronic Immunization Registries System in Chongqing, China, between 2016 and 2020. Univariate and multivariate logistic regression analyses were used to analyze the influence factors. Among the 2,175 children with special health status enrolled in the study, the overall vaccination coverage rate was lower than that among the general population, and the incidence of adverse event in them following immunization was very rare. Children with congenital heart disease were better vaccinated (aOR = 1.508-6.331), while most of the jaundice children had missed vaccination (aOR = 0.441‒0.556). The purchase of vaccine compensation insurance was associated with higher completion rate of basic immunization for Bacillus Calmette-G vaccine (aOR = 1.706, 95% CI: 1.249‒2.329) and rotavirus vaccine (aOR = 1.346, 95% CI: 1.061‒1.708). Children with special health status can be safely vaccinated. However, the vaccination coverage in these huge and vulnerable group is too low to protect them from vaccine-preventable diseases through immunization. More researches and interventions should be conducted to ensure a higher vaccination rate among the children with special health status.

Vaccination deferral among children with seizures in Zhejiang: influence, recommendation, safety and implications

OBJECTIVES

Delayed vaccination in children with seizures was common in China. This study aims to describe the vaccination status, reasons for vaccination deferral, vaccination recommendations and the safety for these patients in Zhejiang.

METHODS

1539 children included were divided into febrile seizure (FS) group, epilepsy (EP) group, unclassified seizure group and other symptomatic seizure group. Medical records and reasons for the vaccination deferral were collected by questionnaire. Vaccination data and Adverse Event Following Immunization were retrieved from vaccination booklets.

RESULTS

The main diseases of children enrolled were FS (756, 49.1%) and EP (443, 28.8%). Most of them (95.6%) were vaccinated on time before the onset of seizure, but their vaccination was delayed after seizure occurred. 76.1% were recommended to receive vaccines normally, of which the FS group accounted for the highest proportion (90.3%). 88.73% of them were vaccinated as recommended, and no serious side effects or seizure occurred. The main reason for vaccination deferral was providers' and parents' hesitation to have them vaccinated.

CONCLUSION

Seizures were overestimated as a contraindication for vaccination in China. Routine vaccination was safe in most circumstances. It is essential to educate providers and parents about the benefits and contraindications of vaccination in children with seizures.