Pneumococcal and Meningococcal Vaccination among Michigan Children with Sickle Cell Disease.

OBJECTIVES: To determine the proportion of Michigan children with sickle cell disease (SCD) who were vaccinated according to pneumococcal vaccination recommendations and, secondarily, to examine uptake of meningococcal vaccine, and to compare up-to-date (UTD) vaccination status between children with and without SCD.

STUDY DESIGN: Children with SCD who were born in Michigan were matched to controls without SCD using age, sex, race, and zip code. Using data from the state immunization registry, we assessed the significance of SCD status on UTD vaccination in logistic regression models.

RESULTS: By 36 months, substantially more children with SCD had completed the pneumococcal conjugate vaccine series (68.8%) than children without SCD (45.2%), and 59% of children with SCD had received a meningococcal vaccine. Compared with children without SCD, children with SCD had higher odds of UTD pneumococcal status at 5, 7, and 16 months. However, a large proportion of children with SCD were missing key vaccination targets: of those who received a full 7-valent pneumococcal conjugate vaccine series, 29.1% had not received a 13-valent pneumococcal conjugate vaccine dose, and 21.8% had not had pneumococcal polysaccharide vaccine administered.

CONCLUSIONS: The pneumococcal and meningococcal vaccination schedules have become increasingly complex in recent years. Assessment algorithms programmed to forecast doses due based on high-risk conditions, such as SCD, could provide a useful reminder to healthcare providers in the context of increasingly complex and changing recommendations.