Vaccination Status of Patients with Spinal Muscular Atrophy: A Multicentre Nationwide SMA-VACC Study

Introduction: Children with chronic neurological diseases such as spinal muscular atrophy (SMA) are at high risk of incomplete or delayed vaccination. This study aimed to assess the age-appropriate vaccination status of SMA patients and evaluate related factors in case of a mismatch. Methods This multicenter, cross-sectional survey was conducted in 13 pediatric neurology clinics across Türkiye. Clinical characteristics, concomitant diseases, and vaccination status according to the National Immunization Program (NIP) were analyzed. Additionally, the rates of non-NIP vaccines (rotavirus, influenza, meningococcal, and HPV) were investigated, and influenza vaccine recommendations were correlated with vaccination rates. Results A total of 315 SMA patients (54.6% male) with a mean age of 7 ± 5.2 years were included. SMA type distribution was 42.5% type 1, 32.7% type 2, and 24.8% type 3. Nusinersen was administered to 95.8% of patients. Age-appropriate vaccination rates according to the NIP ranged from 81.6% (hepatitis A) to 98.7% (BCG). However, the rates for non-NIP vaccines were significantly lower: rotavirus 8.9%, meningococcal 4.2%, and HPV 0.3%. Although 78.7% of patients were recommended the influenza vaccine, the administration rate was only 7.6%, with a significant decline during the COVID-19 pandemic (p = 0.008). The most common reason for incomplete vaccination was prolonged hospitalization due to intensive treatment, while parental vaccine refusal was 1.8%. Conclusion Vaccination rates were low in this nationwide SMA cohort. Well-structured vaccine programs should be implemented to ensure adherence to the NIP schedule and improve non-NIP vaccine uptake.