Immunizations in Children With Chronic Diseases: A State of the Science Review With Implications for Practice Change.

Abstract

Chronic diseases afflict more than 25% of America's children, and it has been reported that some children with chronic illness are underimmunized, compounding their risks of complications from vaccine-preventable infections. To better assess vaccination rates in this population, we systematically reviewed PubMed and CINAHL. Publications were included if specific to immunization rates in U.S. children aged < 18 years and were published between 2010 and 2020. A total of 18 studies were reviewed. Compared with healthy children, children with chronic illnesses have significantly lower vaccination rates, and they face higher risks if they contract a preventable disease. Barriers to on-time vaccinations included inadequate education for both parents and providers and misconceptions from nonmedical sources. In addition, lack of provider comfort serves to lower vaccination rates of children with chronic illness. This topic requires further research and discussion until all children are protected from preventable illness.