title: Acceptance and timeliness of standard vaccination in children with chronic neurological deficits in north-western Switzerland.
abstract: There are no special recommendations for basic vaccinations in patients with chronic neurological deficits distinct from the nationwide advocated schedule in Switzerland. Reports describing adverse neurological events possibly related to vaccinations have attracted public attention. It is unclear if patients with chronic neurological deficits are more reluctantly vaccinated compared to healthy children. We therefore investigated the acceptance of vaccinations in such patients and healthy controls in a retrospective case-control study. At the University Children's Hospital, Basel, Switzerland we investigated 100 patients with chronic neurological deficits and 200 age-matched healthy controls regarding the issue of vaccination rates and ages. The total number of administered vaccinations against diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib), mumps, measles, rubella and hepatitis B were significantly lower in patients compared to healthy controls ( P < 0.01 for each of the respective vaccines). Patients had an increased risk to receive the third pertussis, diphtheria, and tetanus vaccinations (relative risks (RR) for late vaccination 1.53, 1.53, and 1.54 respectively, P < 0.01 for all comparisons), the second (RR = 1.60, P < 0.05) and third Hib vaccinations (RR = 1.52, P < 0.05), and the third polio vaccination (RR = 1.43, P < 0.05) later than controls.
  
  
  CONCLUSIONS
  Children with chronic neurological deficits received fewer vaccinations than healthy controls. In addition, patients received vaccinations later than healthy children. Hence, it may be assumed that children with chronic neurological deficits are at an increased risk to acquire preventable infections. Therefore, vaccination should be promoted as part of the consultation during a routine appointment with the specialist.
authors.affiliation: Department of Neuropaediatrics, University Children's Hospital, P.O. Box, 4005 Basel, Switzerland. btillmann@yahoo.com
authors.forename: Bettina Ute
authors.initials: BU
authors.lastname: Tillmann
authors.forename: Hanns-Christian
authors.initials: HC
authors.lastname: Tillmann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Heininger
authors.forename: Jürg
authors.initials: J
authors.lastname: Lütschg
authors.forename: Peter
authors.initials: P
authors.lastname: Weber
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology*; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*
references.citation: Neurology. 1999 May 12;52(8):1546-52
references.pmid: 10331677
references.citation: Pediatrics. 1991 Aug;88(2):397-400
references.pmid: 1861949
references.citation: JAMA. 1972 Jun 19;220(12):1569-72
references.pmid: 5067732
references.citation: Ther Umsch. 1998 Jan;55(1):8-12
references.pmid: 9492611
references.citation: Arch Pediatr. 2001 Mar;8(3):316-20
references.pmid: 11270259
references.citation: Pediatrics. 1992 Feb;89(2):318-24
references.pmid: 1734402
references.citation: J Pediatr. 2001 Nov;139(5):624-9
references.pmid: 11713437
references.citation: Pediatr Infect Dis J. 2000 Dec;19(12):1127-34
references.pmid: 11144371
references.citation: Pediatrics. 1994 Oct;94(4 Pt 1):517-23
references.pmid: 7936863
references.citation: JAMA. 1999 Aug 11;282(6):547-53
references.pmid: 10450716
references.citation: Acta Paediatr. 2001 Dec;90(12):1421-6
references.pmid: 11853341
references.citation: N Engl J Med. 2001 Aug 30;345(9):656-61
references.pmid: 11547719
references.citation: N Engl J Med. 2001 Oct 4;345(14):1042-53
references.pmid: 11586958
references.citation: JAMA. 2001 Sep 12;286(10):1169-70
references.pmid: 11575310
references.citation: J Clin Epidemiol. 1996 Jun;49(6):697-703
references.pmid: 8656233
references.citation: JAMA. 1990 Mar 23-30;263(12):1679-80
references.pmid: 2308206
references.citation: N Y State J Med. 1947 May 1;47(9):1016
references.pmid: 20295035
references.citation: Epidemiol Infect. 2002 Apr;128(2):185-92
references.pmid: 12002536
references.citation: Eur J Pediatr. 2001 Apr;160(4):203-13
references.pmid: 11317640
references.citation: Arch Pediatr Adolesc Med. 1994 Sep;148(9):926-9
references.pmid: 8075735
references.citation: Ambul Pediatr. 2001 Jul-Aug;1(4):213-6
references.pmid: 11888403