Pneumococcal Vaccination of Children with Chronic Heart Disease

Study Objective: To analyse the vaccination coverage of children with chronic cardiovascular disease hospitalized to the National Medical Research Centre of Children Health during previous for 2018–2019, assess the safety and epidemiological effectiveness of pneumococcal vaccination of children with chronic cardiovascular disease.

Study Design: Retrospective analysis of medical records and vaccination cards; prospective comparative observation one-center study.

Material and Methods. For the period 2018–2019, we analysed 82 cases of children with congenital heart defects (CHD) and cardiomyopathy; 30 children with CHD were vaccinated with conjugated pneumococcal vaccine, and their post-vaccination period and respiratory infections per year after vaccination was analysed.

The study included 82 children aged from 1 month to 7 years, who were on examination and/or treatment in the departments of cardiology and cardiac surgery National Medical Research Center for Children’s Health in the period from January 2018 to January 2020. The parents' questionnaire included questions on the availability/absence of information on the need for vaccination against pneumococcus; the age when vaccination was first carried out; the reason for the lack of vaccination in the child; existence/absence of revaccination within the specified time. All children underwent a standard examination to determine the extent of chronic heart failure (CHF): 72 (87.8%) children had a degree of 2A, 10 (12.2 %) degree of 2B. 30 of 82 children had congenital heart defect, and the remaining 52 had some form of cardiomyopathy. A 13-valent conjugated pneumococcal vaccine was used.

Study Results. During the analysis of the vaccination cards it was found out that the majority of children (66) did not have a single vaccination against pneumococcus, and therefore he carried out the first vaccination in the National Medical Research Centre of Children Health. The remaining children received a second or third dose of the vaccine, or were reacted against pneumococcus, respectively. No child had a full pneumococcal vaccination before the trial. No post-vaccination complications were reported in vaccinated children. Twelve children had elevated body temperature to sub-febrile figures lasting from a few hours to two days, and 13 had low to moderate local responses. The standard follow-up survey did not show an increase in the CHF degree or CHF functional class after vaccination. Before vaccination all children were in the group of the most frequent patients, and during the first year after vaccination, the incidence of acute respiratory viral infections decreased by more than half. No child diagnosed with acute otitis, meningitis, no aggravation or aggravation of the underlying disease.

Conclusion. Pneumococcal vaccination has proven to be safe and effective in healthy children and in children with chronic pathologies, including those with CHF-related cardiovascular disease. Relevant is the development of recommendations for vaccination of this category of patients earlier, including before the operative treatment.

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