Vaccination status of children with special health-care needs visiting a vaccination consultation clinic of a pediatric hospital in Wuxi, China, from 2020 to 2023: A cross-sectional study

There has been a considerable controversy about vaccination practices of children with special health-care needs (CSHCNs) in China. We aim to describe current vaccination recommendations, immunization status, and vaccination safety of CSHCNs in Wuxi. We conducted a cross-sectional study of CSHCNs aged <18 y visiting the vaccination consultation clinic (VCC) at Wuxi Children's Hospital in 2020-2023. Demographic information was collected from Electronic Medical Records, vaccination data was obtained from Vaccination Integrated Service Management Information System of Jiangsu Province, China. Safety monitoring data was acquired from China National Adverse Events Following Immunization Information System (CNAEFIS). Descriptive data were presented as percentages, and Poisson test was used to compare the cumulative incidence of AEFIs between groups. Four thousand one hundred and twenty-two participants were included and the majority (73.0%) were under 12 months. The top three diseases consulted were those relating to the certain conditions originating in the perinatal period, developmental anomalies, and diseases of the blood or blood-forming organs. Only 6.1% had previously received all age-eligible vaccine doses before seeking evaluation. According to the vaccination guidance issued by the VCC, 59.9% were recommended to continue vaccine normally, partial vaccination was recommended for 37.2%, and 4.1% were advised to delay. A total of 3927 CSHCNs received 62,744 vaccine doses after consultation. None had serious adverse events and the cumulative incidence of AEFIs was higher than the general population of children. Specialist consultation is helpful to improve the vaccine uptake. Further research on strategies to improve the vaccination coverage of CSHCNs is warranted.