2nd International Eurasian Congress of Social Pediatrics, Turkey, 26 - 29 November 2020
Background: Pediatric risk groups, such as children with chronic diseases like hematological and oncological
malignancies, congenital or acquired immunocompromised conditions, may not be adequately
or routinely vaccinated despite being more susceptible to complications from vaccine preventable diseases.
Recommendations for immunization of these high-risk group children can be inconsistent. This
may be due to lack of immunization recommendations, lack of awareness, or incomplete adherence to
existing guidelines. This cross-sectional study assessed attitudes regarding immunization in high-risk
groups of children with underlying conditions, among pediatricians working in the field of social pediatrics.
Method: This study used a cross-sectional electronic survey with 75 pediatricians working in the field
of Social Pediatrics in Turkey between October and December, 2020. A web-based questionnaire which
consisted questions about the attitudes of immunization of children with cancer, bone marrow or solid
organ transplantation, asplenia/splenectomy, congenital or acquired immune deficiency, hemoglobinopathy,
chronic cardiac or respiratory disease, inherited metabolic disorders, inflammatory bowel disease,
and patients treated with biological agents, was designed. Statistical analysis has been performed
with SPSS for Windows 7.0 package program.
Results: Recommendations and routine practices for immunization varies between centers. Majority
of the participants use current recommendations and guidelines. Common problems are the different
approach pediatric disciplines about immunization in high-risk children (58.5%), private vaccines paid
by the parents (94.4%), inappropriate contraindications for vaccine use/delay by the department that
follows up the patient(47.1%), the lack of vaccines in the country (62.7%), the fact that the different disciplines
have different vaccination practices (44.9%), and the department that follows up the child does
not provide sufficient explanatory information about the disease and immunization (57.7%). There are
differences for routine practices for immunization between the participants, mainly; serological tests
before immunization in children with cancer, vaccine schedule and time interval after chemotherapy,
immunization protocol for children receiving blood and blood products, immunization of children with
graft-versus host disease, immunization of children with congenital immune deficiencies, immunization schedules for vaccines which are not a part of national immunization program, administration of
live vaccines after solid organ transplantation, immunization of previously hepatitis B immunized children
who have Anti-HBs level as
Conclusion: Recommendations for immunization in high-risk children or children with underlying conditions
may vary across in our country. Interventions as harmonization of the routine practices with a
national guideline aimed at the enhancement of attitudes and awareness of pediatricians who provide
immunization of children with high-risk groups or underlying conditions.
Keywords: Children, Immunization,Immunocompromised conditions, Chronic diseases,Social Pediatrics