Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.
- Presentation
Hit Me With Your Best Shot! Pediatric Vaccines - Best Practices for the Use of Vaccinations in Special Populations within Dermatology
Description
The presentation focused on best practices for pediatric vaccinations, particularly in special populations with dermatological conditions, and emphasized the shared responsibility between dermatologists and pediatricians when managing immunosuppressive therapies. The importance of vaccination was highlighted with historical context and data showing significant reductions in disease rates due to vaccinations. The presenter discussed vaccine hesitancy and rising non-medical exemptions, noting the economic and health impacts of outbreaks. Emphasis was placed on the need for thorough immunization histories before starting immunosuppressive treatments, the timing of vaccines, and the recommendations from CDC and professional organizations. Best practices included administering live vaccines four weeks prior to starting immunosuppressive agents and checking Hepatitis B titers if relevant. The discussion on specific vaccines and scenarios included the responses to live vaccines in immunocompromised children and considerations for travel vaccinations. The talk addressed the integration of COVID vaccines into care for immunosuppressed pediatric patients and specific details on dupilumab use concerning vaccines. The session encouraged shared decision-making between healthcare providers and families to optimize vaccination strategies while considering therapies for skin diseases. Overall, the key message was to ensure pediatric patients are vaccinated appropriately, especially before starting immunosuppressive therapies.
View moreConclusions
- Vaccines significantly reduce infections in pediatric populations, leading to a decrease in morbidity and economic burdens associated with vaccine-preventable diseases.
- Managing vaccines for pediatric patients on immunosuppressive therapies is a shared responsibility between healthcare providers and requires detailed communication and coordination.
- Delays in immunosuppressive therapy may be necessary to ensure pediatric patients receive timely vaccinations, especially before starting immunosuppressive medications.
- Current trends show a rise in non-medical vaccine exemptions, making it challenging to achieve herd immunity and raising risks of vaccine-preventable disease outbreaks.
- Vaccine hesitancy remains a concern, largely influenced by misinformation and social factors, which can impact vaccination rates among children.
- Immunization histories should be reflected in electronic medical records to ensure follow-up and proper vaccine administration in pediatric patients, particularly those on immunosuppressive therapies.
- Additional care should be taken to check antibody titers before starting immunosuppressive therapies to identify patients who may require vaccination boosts, especially for Hepatitis B.
- Live vaccines should generally not be given during high-dose immunosuppressive therapy, while inactivated vaccines might still be administered but with caution regarding immune response.
- Continued monitoring and education regarding vaccinations for both patients and their household contacts is necessary to prevent the spread of preventable diseases, especially in immunocompromised patients.
- CDC Epidemiology and Prevention of Vaccine-Preventable Diseases, 11th ed, 2009.
- Hotetz P, PLOS Med, 2016.
- Seither R, Laury J, Mugerwa-Kasujja A, Knighton CL, Black CL. Vaccination Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten - United States, 2020-21 School Year. MMWR Morb Mortal Wkly Rep 2022;71:561-568.
- Seither R, Yusuf OB, Dramann D, Calhoun K, Mugerwa-Kasujja A, Knighton CL. Coverage with Selected Vaccines and Exemption from School Vaccine Requirements Among Children in Kindergarten - United States, 2022-23 School Year. MMWR Morb Mortal Wkly Rep 2023;72:1217-1224.
- Patel DP et al, Vaccine, 2017.
- Groot N et al, Vaccine, 2017.
- Heijstek et al, Ann Rheum Dis, 2007.
- Borte S et al, Rheumatology, 2009.
- Uziel, Vaccine, 2020.
- Weschler ME, Souza-Machodo A, Xu C, Mao X, Kapoor U, Khokhar F, et al. Preclinical and clinical experience with dupilumab on the correlates of live attenuated vaccines. J of Allergy and Clinical Immunology: Global, Vol 1, Issue 1, 2022; 9-15.
- Siegfried EC, et al. A case series of live attenuated vaccine administration in dupilumab-treated children with atopic dermatitis. Pediatr Dermatol. 2024 Feb 2.
- Martinez-Cabriales SA, Kirchhof MG, Constantinescu CM, Murguia-Favela L, Ramien ML. Recommendations for Vaccination in Children with Atopic Dermatitis Treated with Dupilumab: A Consensus Meeting, 2020. Am J Clin Dermatol. 2021 Jul;22(4):443-455. doi: 10.1007/s40257-021-00607-6. Epub 2021 Jun 2. PMCID: PMC8169786.