Article Text

ROUTINE IMMUNISATION OF HIV-INFECTED CHILDREN: FAILING TO PROTECT A HIGH-RISK POPULATION
  1. A Bamford1,2,
  2. Y Lees1,
  3. B Kampmann2,
  4. J Daniels1
  1. 1Department of Paediatrics, North Middlesex Hospital, London, UK
  2. 2Department of Paediatrics, Division of Medicine, Imperial College London, London, UK

Abstract

Objectives HIV-infected children are at increased risk from vaccine preventable disease, even if receiving highly active antiretroviral therapy. It is therefore essential that they are fully immunised according to national guidelines. We present data on the immunisation status of children attending a north London paediatric HIV clinic.

Methods Audit of immunisation status of children attending a paediatric HIV clinic. Immunisation histories were obtained from child health records, GP, health visitor and parental recall. Each child’s status was compared with UK guidelines on immunisation of HIV-infected children.

Results Information on all 22 vertically infected children was obtained: Mean age 10.2 years, male : female 10 : 12, 16 UK born, 19 black British/African. Vaccination against 11 infections is currently recommended. Only 2/22 children were fully immunised, 17/22 were deficient in two or more vaccines, 5/22 were deficient in six or more, 4/22 were deficient in 10 or more. All six children born abroad were deficient in five or more vaccines. The most frequently omitted vaccine was pneumococcal (PPV/PCV); 18/22 were unimmunised. MMR and meningitis C vaccines were also frequently missed; 9/22 unimmunised for MMR and 9/22 unimmunised for meningitis C.

Conclusions Immunisation of HIV-infected children is currently inadequate. Relatively recently introduced vaccines are being omitted and we are failing to ensure catch-up for immigrant children with incomplete/uncertain vaccination history. The proportion of HIV-infected children born abroad is increasing. With new vaccines being introduced into the UK schedule imminently, the immunisation status of HIV-infected children should be thoroughly assessed and catch-up immunisation provided.

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