Vaccination practice and safety in children with special health care needs: A retrospective study of 1278 children.

Children with special health care needs (CSHCN) are at increased risk of vaccine-preventable diseases, yet concerns about safety often lead to delayed or incomplete immunization. We conducted a retrospective analysis of 1278 CSHCN attending the Special Vaccination Consultation Clinic of Kunming Children's Hospital in Yunnan Province, China, between January 2023 to December 2024. We examined their disease spectrum, vaccination recommendations, and incidence of adverse events following immunization (AEFI). The cohort had a male-to-female ratio of 1.3:1, with infants aged 0-1 y constituting the majority (56.4%). Neurological (38.3%), neonatal (33.6%), and cardiovascular diseases (21.4%) predominated the consultation spectrum, with a marked age-dependent shift from neonatal conditions in early infancy to neurological disorders thereafter. Following specialist evaluation, 92.5% of children received vaccination advice: 76.7% were recommended for standard or single-dose sequential vaccination, and 15.8% for inactivated vaccines only; only 2.7% were advised to defer all vaccinations. Among 1182 children who were subsequently vaccinated, 174 reported AEFI, yielding an incidence of 14.7%. Fever was the predominant manifestation (70.7% of AEFI), and the vast majority (99.4%) of events occurred in children under 4 y of age. This study demonstrates that under the guidance of a specialized vaccination clinic, over 90% of CSHCN can be safely vaccinated. Individualized assessment based on age and disease characteristics is pivotal to ensuring immunization in this vulnerable population, thereby safeguarding their right to protection against vaccine-preventable diseases.