Barriers to vaccination in immunocompromised children: A needs assessment in children with childhood-onset SLE and inflammatory bowel disease.

Background: Vaccination of immunocompromised children (ICC) remains suboptimal.

Methods: Needs assessment surveys were administered to patients and caregivers during routine ambulatory visits to the rheumatology and gastroenterology clinics at Nationwide Children's Hospital (NCH) from January 1 through August 31, 2018, and to community primary care physicians (PCPs) at their monthly meeting and electronically.

Results: Completed surveys were received for 57 patients 31 with childhood-onset systemic lupus erythematosus (c-SLE) and 26 with inflammatory bowel disease (IBD)) and 30 PCPs. Of the patient cohort, 93% ( = 53) felt their PCP was well informed about vaccines and 84% ( = 47) received vaccinations from either their PCP or local health department. Two patient surveys noted concerns of vaccine safety. Among the 30 responses completed by PCPs 50% ( = 15) preferred to provide all vaccines themselves, however, only 40% ( = 12) of PCPs felt "very confident" when providing vaccines to ICC. Further, 83% ( = 25) did not stock the 23-valent pneumococcal vaccine and only 27% ( = 8) routinely recommended vaccination of household contacts.

Conclusions: Our study found a discordance between parent and PCP comfort in vaccinating ICC, highlighting an important barrier to vaccination in this patient population. In our cohort of patients, vaccine hesitancy was not a barrier to vaccination.