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Influenza is one of the most common respiratory diseases. Infections caused by this virus may be very serious and can lead to severe complications. So far, the most effective method of protection against influenza is annual vaccination. The Advisory Committee on Immunisation Practices recommends vaccination against influenza for some groups of people. Unfortunately, in spite of these clear indications, a large number of patients are not vaccinated. This article reviews the current scientific literature on immunological response to influenza vaccination in patients who are at especially high risk for serious post-influenza complications and for whom immunisation against this virus is strongly recommended. Results of studies carried out in Poland and other countries in elderly people, in patients with pulmonary diseases, renal diseases, diabetes mellitus, cancer and haemophilia, and in those with HIV infection are presented. In this review, we focus on the immune response to haemagglutinin. There are some discrepancies between the results of studies carried out by different authors in high risk groups of patients. Some investigations indicated poorer humoral response to influenza vaccine in these groups, while others showed responses comparable to those in healthy individuals. These differences may be explained by differences in types and stages of the chronic diseases, in the treatment and composition of influenza vaccines, and also patients' ages, vaccination history and prevaccination antibody titres. Influenza vaccines are well tolerated in high risk patients, and all adverse reactions are generally mild and similar to those observed in healthy people. Although, in some cases, immunological responses to influenza vaccination measured in the whole study group were poor, there were some individual patients who, after vaccination, developed antihaemaglutinin antibody titres which are considered to give protection against the infection or contribute to a milder course of the disease.

The aim of this pilot study was to assess a humoral response to influenza vaccine in 9 women with breast cancer. In the epidemic season 1998/1999 the patients received a single 0.5-ml dose of split influenza vaccine (Vaxigrip, Pasteur Merieux). Humoral response was measured by the hemagglutinin inhibition test in sera collected before vaccination and 1 month after vaccination. All results were compared with a control group of 19 healthy vaccinated women. The mean 'fold' increases ranged from 12.0 to 22.2 in patients with breast cancer and from 10.5 to 29.2 in healthy women. After vaccination, protection rates ranged from 44.4% to 88.9% and 63.2% to 94.7%, respectively. Response rates were between 44.4% and 88.9% in women with cancer and between 63.2% and 78.9% in the control group. After vaccination, antihaemagglutinin antibody titers were significantly higher than the prevaccination titers. During the whole study there were no statistically significant differences in humoral response between patients with breast cancer and healthy women. The results of the present study clearly show that women with breast cancer, including those undergoing chemotherapy, were able to develop a good serological response to influenza vaccine.

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The results indicate that influenza vaccination induces sufficient immune response in pts with NHL, irrespective of previous chemotherapy.

The results obtained in this study indicate that influenza vaccine is immunogenic in patients with acute lymphoblastic leukemia, despite their serious disease.