Suboptimal Immunisations in Children With a Ventriculoperitoneal Shunt-Can We Do Better?

Abstract

Aim: To assess the immunisation status of children with a ventriculoperitoneal (VP) shunt as recommended per the Australian National Immunisation Program (NIP), including additional recommended pneumococcal immunisations. The secondary aim assessed the prevalence of invasive pneumococcal disease (IPD) in this cohort.

Methods: Patients were identified via surgical codes utilising electronic medical records (EMR) over a 5-year period. Patients' EMR and Australian Immunisation Record were accessed to identify immunisation status and prevalence of IPD (as of 30 June 2022).

Results: A total of 245 children were identified, and after exclusion criteria, 207 remained. Of the cohort (n = 207), 86% were up to date with standard NIP immunisations, however only 40% received an additional dose of 13-valent pneumococcal conjugate vaccine (13vPCV). For eligible children, 55% received the first dose of 23-valent pneumococcal polysaccharide vaccine (23vPPV), and only 25% received the second dose of 23vPPV. Overall, 25% of children received all eligible additional pneumococcal immunisations. Only two children were diagnosed with IPD, of which one received all eligible additional pneumococcal immunisations. Both were immunocompromised and neither strain was preventable with current immunisations.

Conclusion: Coverage with routine immunisations in children with a VP shunt is suboptimal compared to Australian national immunisation rates. The rates of additional pneumococcal immunisation for at-risk children are less optimal, placing them at increased risk of vaccine-preventable infections. Strategies should be implemented to increase immunisation completeness in this cohort.