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Immunisation deferral practices surrounding congenital heart surgery

Published online by Cambridge University Press:  01 April 2024

Dana B. Gal Open the ORCID record for Dana B. Gal [Opens in a new window] ,
John D. Cleveland ,
Jeffrey E. Vergales  and
Alaina K. Kipps Open the ORCID record for Alaina K. Kipps [Opens in a new window]
Dana B. Gal*
Affiliation:
Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Division of Pediatric Cardiology, Children’s Hospital of Los Angeles, Los Angeles, CA, USA
John D. Cleveland
Affiliation:
Division of Pediatric Cardiology, Children’s Hospital of Los Angeles, Los Angeles, CA, USA Department of Cardiothoracic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Jeffrey E. Vergales
Affiliation:
Division of Pediatric Cardiology, University of Virginia, Charlottesville, VA, USA
Alaina K. Kipps
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
*
Corresponding author: Dana B. Gal; Email: dgal@chla.usc.edu
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Abstract

Background:

Perioperative immunisation administration surrounding congenital heart surgery is controversial. Delayed immunisation administration results in children being at risk of vaccine-preventable illnesses and is associated with failure to complete immunisation schedules. Among children with CHD, many of whom are medically fragile, vaccine-preventable illnesses can be devastating. Limited research shows perioperative immunisation may be safe and effective.

Methods:

We surveyed Pediatric Acute Care Cardiology Collaborative member centres and explored perioperative immunisation practices. We analysed responses using descriptive statistics.

Results:

Complete responses were submitted by 35/46 (76%) centres. Immunisations were deferred for any period prior to surgery by 23 (66%) centres and after surgery by 31 (89%) centres. Among those who deferred post-operative immunisation, 20 (65%) required deferral only for patients whose operations required cardiopulmonary bypass. Duration of deferral in the pre- and post-operative periods was variable. Many centres included exceptions to their policy for specific vaccine-preventable illnesses. Almost all (34, 97%) centres administer routine childhood immunisation to patients who remain admitted for prolonged periods.

Conclusions:

Most centres defer routine childhood immunisation for some period before and after congenital heart surgery. Centre specific practices vary. Immunisation deferral confers risk to patients and may not be warranted in this population. Further research would be necessary to understand the immunologic impact of these practices.

Keywords

Immunisationcardiopulmonary bypasscongenital heart surgery
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 4
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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