What are the vaccines required for children with chronic respiratory illness?

Children with chronic respiratory diseases have increased risk of infections and infection related complications. There is also an increased risk of hospital acquired exposure to vaccine-preventable diseases due to frequent OPD visits and hospitalizations. Vaccination is crucial for children with chronic respiratory illnesses to help protect them from preventable diseases and complications. Children with chronic respiratory diseases may require additional vaccines beyond the routine childhood immunization schedule due to their increased susceptibility to infections and complications. It has been observed throughout the world that children having chronic respiratory conditions or any other chronic diseases have significantly lower vaccination rates compared to the general population.

In this blog we shall discuss the key vaccines recommended for children with chronic respiratory conditions. The recommendations vary based on specific diagnoses and individual health considerations.

Which respiratory conditions predisposes children to repeated infections?
Several respiratory conditions can predispose children to repeated infections. Some of the common ones include: cystic fibrosis, bronchiectasis, primary ciliary dyskinesia, interstitial lung diseases, chronic aspiration syndrome and bronchopulmonary dysplasia. Children with immune deficiencies, whether primary (genetic) or secondary (acquired due to other conditions or treatments), are at higher risk of infections, including respiratory infections. All children with the above mentioned diagnosis received vaccines as recommended. Children with asthma are not considered to be predisposed to have increased respiratory infections. The recommendations for vaccination are similar to normal, healthy children.

What should be the schedule of routine vaccination for children with chronic respiratory diseases?
Immunization or vaccination rates for routine vaccination have been found to be significantly lower compared to the general population. Schedule vaccination as per the National Immunisation Programme should be administered on time. These routine vaccinations include vaccination for hepatitis B, haemophilus influenzae, pneumococcus, polio, DPT, MMR, hepatitis A and chickenpox vaccine. Vaccines might be less effective and additional doses, or higher doses of vaccines may be required to provide adequate protection.

chronic respiratory illness

Children with chronic respiratory diseases should be immunized with both live and killed (e.g., inactivated or recombinant) vaccines. If the child is immunocompromised due to the disease or any medicine the child is receiving, live vaccines (oral polio drops and MMR) should not be administered. Vaccination should be done early in the disease as the immune response is better.

What additional vaccines are required in children having chronic respiratory diseases?
Children with chronic respiratory diseases are at a risk of serious complications if they catch flu infection. Annual influenza or flu shots are recommended for children with chronic respiratory diseases. Children with chronic respiratory diseases are at higher risk of invasive pneumococcal disease. Hence, children with chronic respiratory diseases should receive pneumococcal vaccines.

There are two main types of pneumococcal vaccines that are commonly used; Pneumococcal conjugate vaccines (PCV) and Pneumococcal polysaccharide vaccines (PPSV). Pneumococcal conjugate vaccines (PCV) induce a stronger immune response and are administered at 6, 10, 14 weeks of age to all children. Various Pneumococcal conjugate vaccines (PCV) are available in India. PPSV is a special vaccine which provides extended coverage. It is used only in adults and older children who are at higher risk of pneumococcal infections. It can only be given after 2 years of age. Children with chronic lung diseases should receive both PCV and PPSV.

If your child is having any chronic lung disease or repeated respiratory problems get in touch with your child pulmonologist for a detailed discussion on the vaccination schedule.

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