Assessment of vaccination adherence in pediatric rheumatologic patients: preliminary results

Abstract Background Rheumatologic diseases, although traditionally associated with adults, increasingly affect the pediatric population. Juvenile idiopathic arthritis (JIA) is the most frequent condition, with both disease and immunosuppressive treatments heightening infection risk. Vaccination is crucial yet often insufficient. This study aimed to assess vaccination coverage among pediatric patients with rheumatologic diseases, and to explore willingness to complete missed immunizations. Methods A cross-sectional study began in February 2025 at the Italian Teaching Hospital. Parents of patients with rheumatologic diseases completed a structured questionnaire collecting demographic and clinical data, vaccination status, parental risk perception, and sources of vaccine information. Results Among 40 enrolled patients (mean age 12 years ±5.5 DS; 55% male),43% had JIA and 40% autoinflammatory disorders. Vaccination adherence was variable: although primary vaccination with hexavalent vaccine was satisfactory, 40% lacked complete pneumococcal vaccination, and meningococcal vaccines coverage was below 50%. Only 13% received the seasonal flu vaccine, and none of patients received COVID-19 seasonal vaccination dose. Missed vaccinations were mainly due to absence of medical recommendation (60%), parental hesitancy (20%), or temporary contraindications (4%). Main information sources were pediatricians (78%) and social media (42%). Conclusions Preliminary findings confirm low vaccination adherence in pediatric rheumatologic patients, particularly for pneumococcal and influenza vaccines, despite strong clinical recommendations. Public health actions are needed to implement personalized vaccination pathways, ensuring regular reassessment of vaccination status and enhanced education of parents and healthcare providers. Key messages • Pediatric rheumatology patients show suboptimal vaccination rates, requiring personalized and reinforced vaccination strategies. • Improved parent education and healthcare provider collaboration are crucial to enhance vaccine adherence in vulnerable pediatric groups.