Undervaccination of Perinatally HIV-infected and HIV-exposed Uninfected Children in Latin America and the Caribbean

Autor: Regina C M, Succi, Margot R, Krauss, D Robert, Harris, Daisy M, Machado, Maria Isabel, de Moraes-Pinto, Marisa M, Mussi-Pinhata, Noris Pavia, Ruz, Russell B, Pierre, Lenka, Kolevic, Esau, Joao, Irene, Foradori, Rohan, Hazra, George K, Siberry
Rok vydání: 2013
Předmět:
Zdroj: Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual)
Universidade de São Paulo (USP)
instacron:USP
ISSN: 0891-3668
Popis: Preventive health care, including immunization, is an essential part of comprehensive care that can minimize adverse health outcomes for perinatally HIV-infected children and adolescents. Based on evidence of safety, immunogenicity and, in some cases, efficacy of most childhood vaccines for children with HIV infection, guidelines [1, 2, 3] have been developed for recommended immunization in this population. However, health care staff responsible for immunization delivery may miss opportunities for immunizing HIV-infected children because they are unaware of those recommendations, they are concerned about greater risk with use of vaccines in this population, or other reasons. African [4, 5] and European studies [6,7, 8] found lower immunization coverage of HIV-infected children compared to uninfected peers, while a North American study found equally low vaccine coverage, for both HIV-infected and the HIV-exposed uninfected populations for some vaccines [9]. In a rural South African population, maternal HIV-positive status was independently associated with lower vaccination rates for four vaccines in children 12–23 month of age (BCG, DTP3, poliomyelitis, and hepatitis B) [10]. Childhood immunization adequacy can be used as an indicator of children´s primary health care and perhaps highlight areas for improvement. Yet, immunization coverage for HIV-infected children in Latin America and the Caribbean has not been described. Given the importance of vaccination for HIV-infected children and the data from other regions suggesting that they are at higher risk of under-immunization, we evaluated immunization rates, vaccine adverse events (cases associated with polio and BCG vaccines), and the occurrence of vaccine preventable diseases among HIV-exposed uninfected (HEU) and perinatally HIV-infected (PHIV) children in Latin America enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI).
Databáze: OpenAIRE