Introduction
Children with sickle cell disease are at increased risk of serious infections, many
of which can be prevented by receipt of recommended immunizations. Study objectives
were to (1) assess the primary immunization series coverage among children with sickle
cell disease and (2) compare the coverage with that of those without sickle cell disease.
Methods
The Michigan Care Improvement Registry was used to obtain primary immunization series
doses and sickle cell disease status for all eligible children in Michigan born in
2001–2016 (analysis was conducted in 2019). Completion of series and each individual
vaccine were assessed for every child at ages 19 and 35 months. Proportions were stratified
by sickle cell disease status and compared using chi-square tests. Logistic regression
was used to model the odds of completing the series at each age, as predicted by sickle
cell disease status and adjusting for the presence of Medicaid identification number.
Results
The proportion of children who completed the immunization series was higher for those
with sickle cell disease than for those without sickle cell disease at 19 months (58.5%
vs 48.0%) and 35 months (74.7% vs 59.6%) (both p<0.0001). The odds of completing the series were 1.4 times higher at 19 months (95%
CI=1.2, 1.6) and 1.7 times higher at 35 months (95% CI=1.5, 2.0) for children with
sickle cell disease than for those without, adjusting for the presence of Medicaid
identification number.
Conclusions
Although children with sickle cell disease had higher immunization rates than those
without sickle cell disease, >40% of children with sickle cell disease did not receive
all recommended immunizations by age 19 months. Immunization information systems should
be utilized to improve routine immunization coverage of children with sickle cell
disease.
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Article Info
Publication History
Published online: March 11, 2021
Identification
Copyright
© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
