1456 A Survey of Paediatricians Practices and Knowledge About Pneumococcal Vaccines in High Risk Children Before the Era of Universal Immunisation

Aims and Background: We aimed to assess the knowledge and practice of paediatricians in the Trent region of England about the Chief Medical Officer's (CMO) recommendations for the pneumococcal vaccines (PV) to high-risk children before the introduction of the vaccine into the routine universal immunisation programme in Sept 2006. Methods and Design: A total of 68 self-administered questionnaires were returned from a total of 100 posted out to paediatricians in the Trent region. Results: 89% of the paediatricians were aware of the CMO's recommendations of pneumococcal and influenza vaccines to high risk children. The most correctly identified high risk groups for PV were children with asplenia / splenic dysfunction (71%), chronic lung disease (69%), previous invasive pneumococcal disease (65%), congenital heart disease (63%), neuromuscular diseases (59%), nephrotic syndrome (57%), cystic fibrosis (54%) and chronic heart failure (54%). Table 1 Table 1 The least correctly identified high-risk groups were children previously admitted for asthma or a lower respiratory tract disease (9% each), cirrhosis (28%), patients with CSF shunts (31%), following renal transplant (37%), on chemotherapy or steroids (38%) and chronic liver diseases (38%). Conclusion: Most paediatricians were aware of the CMO's recommendations on pneumococcal vaccines for high-risk children. This knowledge however was poorly translated into correct advice given to patients. The introduction of PV into the universal immunisation schedule would enable all the high-risk children to be optimally protected and not subjected to the unreliable knowledge of their busy paediatricians and ”postcode lottery” effect.