Suboptimal vaccine coverage for preventable respiratory infections in children with cystic fibrosis in the Cystic Fibrosis Regional Reference Centre of Tuscany: Need for improving preventive strategies

Advances in standards of care and the recent introduction of Cystic Fibrosis transmembrane conductance regulator (CFTR) modulators have significantly improved the prognosis for individuals with cystic fibrosis (CF). Prevention of respiratory infections in children with cystic fibrosis (cwCF) remains a cornerstone of treatment. Health authorities recommend both mandatory and non-mandatory vaccinations. This retrospective study aims to analyze compliance with the free vaccination program for preventable respiratory diseases in cwCF. This retrospective study assessed compliance with mandatory (H. influenzae type B, Bordetella pertussis) and non-mandatory (S. pneumoniae, COVID-19, Influenza) vaccinations for preventable respiratory diseases in cwCF in regular follow-up at the Regional Reference Center of Tuscany. Regarding mandatory vaccination, 131 (98.5%) out of 133 cwCF were regularly vaccinated, showing good coverage for Haemophilus influenzae type b(Hib). Influenza vaccination coverage peaked during the COVID-19 pandemic, reaching 79.6% in 2020–2021, then declined in the post-pandemic period across all age groups. For pneumococcal vaccination, 97% of cwCF received a complete primary series. Regarding COVID-19 vaccination, 67 (50.3%) out of 133 cwCF received at least two doses; no patients under 7 y were vaccinated. Coverage for pneumococcal and Hib vaccines was excellent. Conversely, Influenza and COVID-19 vaccinations had coverage below the targets set by health authorities. Further studies are needed to understand parental reasons for non-compliance and to develop strategies to increase Influenza and COVID-19 vaccination coverage in this high-risk cohort.