| Autor: |
Lastrucci V; Epidemiology Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy., Puglia M; Observatory of Epidemiology, Regional Health Agency of Tuscany, Via Pietro Dazzi, 1, 50141 Florence, Italy., Pacifici M; Observatory of Epidemiology, Regional Health Agency of Tuscany, Via Pietro Dazzi, 1, 50141 Florence, Italy., Buscemi P; Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy., Sica M; Epidemiology Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy., Alderotti G; Epidemiology Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy., Belli G; Neonatology and Neonatal Intensive Care Unit, Azienda Sanitaria Locale Toscana Centro, Piazza Santa Maria Nuova, 1, 50122 Firenze, Italy., Berti E; Neonatal Intensive Care Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy., Rusconi F; Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Via Cocchi 7/9, 56121 Pisa, Italy., Voller F; Observatory of Epidemiology, Regional Health Agency of Tuscany, Via Pietro Dazzi, 1, 50141 Florence, Italy. |
| Abstrakt: |
Preterm and small-for-gestational-age (SGA) infants are more susceptible to vaccine-preventable diseases. To evaluate routine vaccination timeliness in these high-risk groups, a full birth cohort of infants ( n = 41,502) born in 2017 and 2018 in Tuscany was retrospectively followed up until 24 months of age. Infants were classified by gestational age (GA) and SGA status. The vaccinations included: hexavalent (HEXA), measles-mumps-rubella, varicella, pneumococcal conjugate (PCV), and meningococcal C conjugate. Time-to-event (Kaplan-Meier) analyses were conducted to evaluate the timing of vaccination according to GA; logistic models were performed to evaluate the associations between GA and SGA with vaccination timeliness. Time-to-event analyses show that the rate of delayed vaccine receipt increased with decreasing GA for all the vaccinations, with a less marked gradient in later vaccine doses. Compared to full-term infants, very preterm infants significantly showed an increased odds ratio (OR) for delayed vaccination in all the vaccinations, while moderate/late preterm infants only showed an increased OR for HEXA-1, HEXA-3, PCV-1, and PCV-3. SGA infants had a significantly higher risk of delayed vaccination only for HEXA-1 and PCV-1 compared to non-SGA infants. In conclusion, vaccinations among preterm and SGA infants showed considerable delay. Tailored public health programs to improve vaccination timeliness are required in these high-risk groups. |
