Abstract:
Background: Children with immune mediated inflammatory disorders
(IMIDs) are at an increased risk of various types of vaccine preventable
diseases. Appropriate immunization practices are therefore key for
survival, and for improving the treatment outcomes in these children.
This study explored the perceptions of caregivers and healthcare
workers regarding vaccination for children with IMIDs at Kenyatta
national hospital and Getrude’s children hospital, in Nairobi Kenya.
Methods: This was a mixed-methods study involving interviewer
administered questionnaires for caregivers, self-administered
questionnaires for health workers, and focus group discussions for
caregivers of children suffering from IMIDs and attending the
rheumatology clinics at the Kenyatta National Hospital and Gertrude’s
Children’s Hospital. The study included 103 primary caregivers of
children aged 0-18 years with IMIDs and 76 healthcare workers.
Results: Most of the caregivers (80%) were female; and two thirds
(66%) had attained secondary education or higher. Most (90.6%)
caregivers believed that vaccines are safe, 88.2% that vaccines are
effective, 97.1% had full trust in vaccines and would readily accept their
children to be vaccinated. Further, the caregivers (92.5%) knew that
their children could benefit from additional vaccines (other than the
routine childhood EPI listed vaccines) and would support additional
vaccines for their children if recommended by a doctor. However, only
10.6% (10/103) of caregivers reported that their children had already
received at least one of the additional vaccines. Some caregivers (9.4%)
expressed fears and misgivings about the additional vaccines for their
children. These misgivings include the risk of adverse events following
immunization that the children were too young for additional vaccines,
or that the child was unwell at the time. The health workers supported
the need for additional vaccines for children with IMIDs and vaccine
education for caregivers and health workers.
Conclusion: Most caregivers and healthcare workers of children with
IMIDs accepted and supported additional vaccines, over and above
those administered in the routine EPI programme, for children with
IMIDs. The biggest promoter of vaccine acceptance and uptake was
recommendation of vaccination by health workers while potential
barriers included vaccine safety concerns, inadequate vaccine
knowledge and concerns of vaccine cost and accessibility.