Current Status of BCG and OPV Vaccination in Children with Primary Immunodeficiency in Chongqing, China

Objective: To actively monitor patients with primary immunodeficiency under the age of 18, understand the risk of adverse reactions after vaccination, and provide reference for developing vaccination evaluation measures for children with special health conditions. Methods A questionnaire survey was conducted on patients diagnosed with primary immunodeficiency who visited the Rheumatology and Immunology Department of Children’s Hospital of Chongqing Medical University from January 2022 to March 2023, collecting diagnosis and treatment information as well as the vaccination records of live vaccines; Collected two stool samples (with an interval of more than 24 hours) for virus detection, and analyzed the vaccine derived poliovirus. Results A total of 26 primary immunodeficiency patients were enrolled among 3312 monitored cases, including 5 cases of severe combined immunodeficiency, 7cases of primary antibody deficiency, and 14 cases of other types of immunodeficiency. Among the 21 cases with clear vaccination records, the vaccination rate of BCG and oral poliovirus vaccine were 95.24% and 71.43%, respectively. Among them, the vaccination rates of both vaccines for patients with severe combined immunodeficiency were 100% and 60.00%, respectively; and for patients with primary antibody deficiency were 100%. It was found that one patient with severe combined immunodeficiency had disseminated BCG infection after vaccination, and type Ⅲ immunodeficiency-associated vaccine-derived poliovirus was detected in his stool samples. Conclusions The proportion of primary immunodeficiency patients receiving live vaccines is high, and there is a risk of adverse reactions after vaccination, which brings a challenge to the goal of polio eradication. It is recommended to improve the awareness and ability of recognizing vaccination for children with immunodeficiency, promote the active monitoring of children with immunodeficiency in hospitals, and adjust the immunization strategy for polio vaccine in a timely manner.