Pediatric Research and Child Health

Annual Influenza Vaccination of Household Contacts of Immunocompromised Children with Kidney Disease

Author(s): Hina Zaidi, Robert Woroniecki, Christy Beneri

Background: Annual influenza vaccination (FV) is essential for household contacts (HC) of renal patients on immunosuppression (IS) to reduce secondary transmission. However, vaccination rates (VR) of HC are unknown. Our objective was to examine and optimize preventative strategies to improve them. 
Methods: HC of pediatric renal transplant recipients (RT) and of those with nephrotic syndrome (NS), were surveyed on their (and their child’s) vaccine status over 3 consecutive periods; A) 2014-2015 pre-educational intervention on FV importance, B) 2015-2016 posteducational intervention, and C) 2016-2017 without additional intervention. 
Results: 15 RT ages 7-12 years old and 15 NS ages 4-19 years old were enrolled. 93% RT and 87% NS received FV in period A; 86% RT and 69% NS patients in period B; and 77% RT and 88% NS received FV in period C (accounting for lost follow ups). Household’s fully vaccinated based on degree of patient IS: mild, moderate, severe were 36%, 20% and 45% respectively. Non- Hispanic households had higher VR compared to Hispanic households. In period C, 19% of caregivers were accepting FV who previously were not, however a total of 34% of caregivers did not receive FV despite prior education and reminders in the previous year. 
Conclusions: Although children’s vaccination rates were high, rates for household contacts were poor. More than 50% of caregivers reported reasons against FV; 1) confidence in their health, and 2) vaccines causing more harm than benefit. Post-educational intervention had minimal positive impact on FV rate. Families have FV misperceptions and underestimate the infectious risk they pose to their child.

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