THE CLINICAL COURSE OF COUGH IN FULLY IMMUNIZED AND NON-IMMUNIZED CHILDREN: A PROSPECTIVE OBSERVATIONAL STUDY
Keywords:
Cough, children, immunization, clinical course, respiratory infections, vaccinationAbstract
Background: Cough is a common clinical symptom in children and can result from a variety of infectious and non-infectious etiologies. Immunization against respiratory pathogens such as Bordetella pertussis, influenza viruses, and Streptococcus pneumoniae may alter the clinical course of cough. This study aimed to compare the clinical course of cough between fully immunized and non-immunized children. Methods: In a prospective, multicenter observational study, 500 children aged 6 months to 12 years presenting with cough were enrolled over a 2-year period. Two cohorts were defined based on immunization status: fully immunized (n = 250) and non-immunized (n = 250) according to the national vaccination schedule. Clinical parameters—including cough duration, severity (using a standardized cough scoring system), associated symptoms, need for antibiotic or antitussive therapy, and hospitalization rates—were recorded at presentation and during follow-up at 7, 14, and 28 days. Microbiological evaluation and radiographic examinations were performed when indicated. Results: Fully immunized children demonstrated a milder clinical course with a shorter median cough duration (6 days vs. 9 days, p < 0.001) and lower severity scores compared to non-immunized children. The rate of complications, such as secondary bacterial infections and hospital admissions, was significantly lower in the immunized group (5% vs. 12%, p = 0.005). Multivariate analysis revealed that full immunization was independently associated with reduced cough severity (adjusted OR 0.45, 95% CI 0.30–0.68, p < 0.001) after controlling for age, nutritional status, and underlying respiratory conditions. Conclusions: Full immunization is associated with a less severe clinical course of cough in children. These findings support the role of vaccination in mitigating the morbidity associated with common respiratory infections and highlight the importance of adherence to immunization schedules.
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