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Pediatr Blood Cancer. 2018 Oct;65(10):e27282. doi: 10.1002/pbc.27282. Epub 2018 Jun 15.

Pneumococcal vaccination coverage among children with sickle cell anemia, sickle cell trait, and normal hemoglobin.

Author information

1
Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan.
2
Michigan Department of Health and Human Services, Lansing, Michigan.
3
Department of Epidemiology, University of Michigan, Ann Arbor, Michigan.

Abstract

BACKGROUND:

Children with sickle cell anemia and sickle cell trait are at an increased risk of invasive pneumococcal disease compared to children with normal hemoglobin. We assessed and compared pneumococcal vaccination status among these three groups.

PROCEDURE:

Children with sickle cell anemia and sickle cell trait were identified using Michigan newborn screening records (1997-2014); each child was matched to four children with normal hemoglobin based on age, Medicaid enrollment (at least 1 year from 2012-2014), race, and census tract. Vaccination records were obtained from the state's immunization system. Pneumococcal vaccine coverage (PCV7 or PCV13 depending on date of administration) was assessed at milestone ages of 3, 5, 7, and 16 months. The proportion of children with vaccine coverage at each milestone was calculated overall and compared among children with sickle cell anemia, sickle cell trait, and normal hemoglobin using chi-square tests.

RESULTS:

The study population consisted of 355 children with sickle cell anemia, 17,319 with sickle cell trait, and 70,757 with normal hemoglobin. The proportion of children with age-appropriate pneumococcal vaccination coverage was low at each milestone and generally decreased over time. Children with sickle cell anemia were more likely to be covered compared to children with sickle cell trait or normal hemoglobin.

CONCLUSIONS:

Despite higher pneumococcal vaccination coverage among children with sickle cell anemia, opportunities for improvement exist among all children. Targeted interventions will benefit from mechanisms to identify children with increased risks such as sickle cell anemia or trait to improve pneumococcal vaccination coverage among these groups.

KEYWORDS:

Medicaid administrative claims; invasive pneumococcal disease; pneumococcal conjugate vaccine; pneumococcal polysaccharide vaccine; sickle cell anemia; sickle cell trait

PMID:
29905397
DOI:
10.1002/pbc.27282

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