Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Vaccination lags in children with sickle cell disease

Wagner AL et al. J Pediatr. 2018 May;196:223-9.

Key clinical point: Too few children with sickle cell disease (SCD) are receiving Advisory Committee on Immunization Practices–recommended meningococcal and pneumococcal vaccines, including PCV13 and PPSV23.

Major finding: By 36 months old, only 69% of children with SCD had completed the pneumococcal vaccine series, and only 59% had received the meningococcal vaccine.

Study details: The findings are based on a cohort study of children with and without SCD born in Michigan between April 1, 1995, and January 1, 2014.

Disclosures: The authors reported no conflicts of interest. No external funding was noted.

Source: Wagner AL et al. J Pediatr. 2018 May;196:223-9.


Wagner AL et al. J Pediatr. 2018 May;196:223-9.


Following special vaccine recs for children with SCD essential This study is particularly valuable because of the “depth, breadth and completeness” of data from across an entire state, a control group that is socioeconomically matched, and a study that was done during a time when new, life-saving vaccines were licensed and recommended. The many changes in the recommendations because of new vaccines and new understanding of the best use of these vaccines make for a complex schedule, but we health care providers need to keep current and to educate parents so their children are protected against infectious diseases. For parents of children with sickle cell disease, the schedule is more complex and the need is greater because of their extreme vulnerability. Wagner et al. suggest that “a proactive electronic prompt to providers [and parents] for vaccines needed for children with special conditions [as exists for the general immunization schedule] is needed – and seems doable.” Sarah S. Long, MD, is a professor of pediatrics at Drexel University, Philadelphia. She is an associate editor of the Journal of Pediatrics and the Red Book Report of the Committee on Infectious Diseases of the American Academy of Pediatrics. She reported no disclosures. This is a summary of her editorial accompanying the article by Wagner et al. (J. Pediatr. 2018;196:3).

This Week's Must Reads

Gene sequencing bone marrow in myelodysplastic syndrome, Duncavage EJ et al. N Engl J Med 2018;379:1028-41.

Levofloxacin prophylaxis in ALL, AML , Alexander S, et al. JAMA. 2018;320(10):995-1004

Genetic markers signal poor prognosis in MCL, Obr A et al. Clin Lymphoma Myeloma Leuk. 2018 Aug 23. doi: 10.1016/j.clml.2018.07.282

Disparities in ALL treatment toxicity, Taylor OA et al. Clin Cancer Res. 2018 Sep 11. doi: 10.1158/1078-0432.CCR-18-0939

Leukemia risk after maternal contraception use, Hargreave M et al. Lancet Oncol. 2018 Sep 6. doi: 10.1016/S1470-2045(18)30479-0

Must Reads in Bleeding Disorders

Avatrombopag reduces procedure-related transfusions in chronic liver disease and thrombocytopenia, Terrault N et al. Gastroenterology. 2018 May 17. doi: 10.1053/j.gastro.2018.05.025.

Prehospital plasma improves odds of survival in hemorrhagic shock, Sperry JL et al. N Engl J Med. 2018 Jul 26;379(4):315-26.

Thrombocytopenia in pregnancy raises risk of complications, Reese J et al. N Engl J Med. 2018;379:32-43.

Red cell tranfusion may increase risk of postsurgical VTE, Goel R et al. JAMA Surg. 2018 Jun 13. doi: 10.1001/jamasurg.2018.1565

Dapagliflozin suppresses hepcidin, boosts hematocrit, Ghanim HA et al. AACE 2018, Abstract 228.