Evaluatıon of ımmunıty status ın chıldren wıth congenital heart dısease (chd)

Objective: With this study, it was aimed to determine the routine vaccination schedule and the immunization status of children aged 0-5 years with congenital heart disease who applied to the Pediatric Cardiology Polyclinic of Ankara University Faculty of Medicine between 01.09.2022 and 01.01.2023 for follow-up and also it was aimed to collect information about the causes of the problems in practice. Study design: The infants and children families, aged 0 - 5 years, with congenital heart disease, who applied to the Ankara University Faculty of Medicine Cebeci Hospital Pediatric Cardiology outpatient clinic for follow-up between 01.09.2022 – 01.01.2023, were first filled in the voluntary informed consent form, followed by the Immune Evaluation Form (attached) about protective approaches against infections. The necessary information to fill out the form was obtained from the family and medical records (records in the hospital's information system and the patient's e-nabız records). Demographic information, family information and medical history of the patient were questioned in the immune evaluation form. The routine vaccination schedule of the Ministry of Health, the vaccines to be made out of the calendar, the compatibility of influenza and Respiratuar Sinsityal Virus (RSV) prophylaxis were questioned, and if there was a deficiency in the vaccination, the reasons were recorded. In the presence of conditions that require special vaccination, such as DiGeorge syndrome and asplenia, vaccination compliance was questioned. Results: The total sample number of the study was 154, and the diagnostic distribution of the study group was acyanotic congenital heart disease in 119 (77.3%) cases, and cyanotic congenital heart disease in 35 (22.7%) cases. The mean age of the patients included in the study was 28.85±19.25 months, while 81 (52.6%) were female and 73 (47.4%) were male. There were 150 (97.5%) children whose vaccination status was fully compatible according to the National Childhood Vaccination Schedule of the Turkish Ministry of Health. Of 125 (81.2%) children included in our study group who were in the risk group for influenza indication, 91.2% of them had incompatible fluenza vaccine compliance, while 5.6% were fully compliant. When we look at the reasons for non-compliance, it was seen that 92.4% of them were not emphasized by the healthcare worker who was followed up on the necessity of getting vaccinated. When we evaluated the compliance with the meningitis and rotavirus vaccines that are not included in the routine vaccination schedule, incompatibility was found in the meningitis vaccine in 87.0% of the patients included in our study group, and in the rotavirus vaccine in 84.4%. In addition, it was seen that the highest reason for non-compliance was that the family did not want to have it done because it was paid. It was seen that the reasons for non-compliance were the family's opposition to vaccination and the lack of emphasis on the necessity of vaccination by the health worker who was followed. Conclusion: In our study, it should be aimed that all vaccines included in the Childhood Immunization Calendar of the Ministry of Health should be 100%, although the age-appropriate full vaccination rate and RSV prophylaxis compliance rate is high. Vaccination rates with meningococcal and rotavirus vaccines, which are not included in the Childhood Immunization Calendar of the Ministry of Health, are very low. It was seen that the highest cause of non-compliance was related to the fact that the vaccine was not covered by the Ministry of Health and the family did not want to have it done because it was paid. Despite the fact that the vaccines of the patients in the risk group are covered by the Ministry of Health, the rate of influenza vaccination is very low. It was thought that this may be due to the lack of family guidance and the failure of the healthcare team following this group of patients to focus on heart disease and not emphasize preventive health services adequately. In addition, it is thought that the importance of influenza vaccine should be emphasized in in-service training programs and families and should be followed more closely. The presence of congenital heart disease is not a contraindication for vaccination. Families should be informed about the vaccines included and not included in the Childhood Vaccination Calendar of the Ministry of Health of the Republic of Turkey at every meeting, and close follow-up of vaccines should be done in addition to cardiological disease follow-up. More studies are needed on the vaccination status of children with congenital heart disease and the factors affecting it.