Immunization status of patients with spinal muscular atrophy receiving nusinersen therapy

Arch Pediatr. 2023 Jul;30(5):291-296. doi: 10.1016/j.arcped.2023.03.006. Epub 2023 May 3.


Background: Children with chronic neurological diseases, including spinal muscular atrophy (SMA), are particularly susceptible to vaccine-preventable infections. We aimed to evaluate the age-appropriate immunization status and its relationship with nusinersen therapy in pediatric patients with SMA.

Methods: Children with SMA who received nusinersen treatment were included in this cross-sectional prospective study. Data were collected on SMA characteristics, nusinersen therapy, vaccination status according to the National Immunization Program (NIP), administration, and influenza vaccination recommendation.

Results: A total of 32 patients were enrolled. In patients with SMA type 1, the frequency of under-vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically higher than in patients with SMA type 2-3 (p<0.001). The influenza vaccine was administered to only 9.3% of patients and was never recommended to 13 (40.6%) parents. The frequency of under-vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically higher in patients receiving nusinersen maintenance therapy than in those with loading doses (p<0.001). Physician recommendations for influenza and pneumococcal vaccines were significantly higher in the nusinersen maintenance group (p = 0.029). There was no statistical significance between the groups in terms of administration of influenza and pneumococcal vaccines (p = 0.470).

Conclusion: Children with SMA had lower immunization rates and poor compliance with immunization programs. Clinicians should ensure that children with SMA receive the same preventive health measures as healthy children, including vaccinations.

Keywords: Immunization; Influenza; Nusinersen; Spinal muscular atrophy; Vaccination.

MeSH terms

  • BCG Vaccine / therapeutic use
  • Child
  • Cross-Sectional Studies
  • Humans
  • Influenza Vaccines*
  • Influenza, Human*
  • Muscular Atrophy, Spinal*
  • Pneumococcal Vaccines
  • Prospective Studies
  • Spinal Muscular Atrophies of Childhood*
  • Vaccination


  • nusinersen
  • BCG Vaccine
  • Influenza Vaccines
  • Pneumococcal Vaccines