Vaccination coverage for infants with CHD is unknown, yet these patients are at high risk for morbidity and mortality associated with vaccine-preventable illnesses. We determined vaccination rates for this population and identified predictors of undervaccination. We prospectively enrolled infants with CHD born between 1 January, 2012 and 31 December, 2015, seen in a single-centre cardiology clinic between 15 February, 2016 and 28 February, 2017. We assessed vaccination during the first year of life. Subjects who by age 1 year received all routine immunisations recommended during the first 6 months of life were considered fully vaccinated. We also evaluated influenza vaccination during subjects’ first eligible influenza season. We obtained immunisation histories from primary care providers and collected demographic and clinical data via a parent survey and chart review. We used multivariable logistic regression to identify predictors of undervaccination. Among 260 subjects, only 60% were fully vaccinated. Vaccination rates were lowest for influenza (64.6%), rotavirus (71.1%), and Haemophilus influenzae type b (79.3%). Cardiac surgery with cardiopulmonary bypass during the first year of life was associated with undervaccination (51.5% versus 76.4% fully vaccinated, adjusted odds ratio 2.1 [95% confidence interval 1.1–3.9]). Other predictors of undervaccination were out-of-state primary care (adjusted odds ratio 2.7 [1.5–4.9]), multiple comorbidities (≥2 versus 0–1, adjusted odds ratio 2.0 [1.1–3.6]), and hospitalisation for >25% of the first year of life (>25% versus ≤25%, adjusted odds ratio 2.1 [1.1–3.9]). Targeted quality improvement initiatives focused on improving vaccination coverage for these infants, especially surrounding cardiac surgery, are needed.

As China implements the voluntary vaccination programme of one-dose of varicella vaccine (VarV) for decades, robust estimates of the impact of voluntary vaccination era on epidemiology of varicella are needed. We estimated the vaccination coverage (VC) of VarV by using surveillance data on immunisation. The descriptive epidemiological method was used to describe the changing epidemiology of varicella from 2007 to 2018. The screening method was used to estimate the vaccine effectiveness (VE) of VarV. The overall VC for VarV was 71.7%, ranged from 47.7% to 79.5% among 2008–2017 birth cohorts. In total, 16 660 varicella cases were reported during 2007–2018, the incidence increased from 10.0 cases per 100 000 population in 2007 to 65.2 cases per 100 000 population in 2018. A shift in age group of varicella was observed since 2012, with the age increased from 5–9 years to 10–14 years. The overall VE was 79.9%, and the VE increased from 60.1% in 2008 birth cohort to 96.2% in 2017 birth cohort. We found that the overall VE for VarV is moderate, but appears highly effective within 5 years after vaccination. In addition, a shift varicella infection to older ages has occurred at the long-term moderate level VC of one-dose VarV. Therefore, to contain the incidence of varicella and prevent any potential shift to older ages, the introduction of VarV into routine immunisation programme is likely needed in Lu'an.