Influenza vaccines in immunosuppressed adults with cancer

Eliakim‐Raz, Noa; Vinograd, Inbal; Trestioreanu, Anca Zalmanovici; Leibovici, Leonard

doi:10.1002/14651858.cd008983.pub2

Cited by 37 publications

(36 citation statements)

References 59 publications

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“…Confirmed influenza and pneumonia rates were lower with vaccination, and a reduction in hospitalizations following vaccination was observed. 10 Another prospective cohort study showed Influenza vaccination was associated with lower mortality among adult cancer patients. In spite of these favorable outcomes with immunization, coverage rates for these vaccines in adults are markedly lower than the rates among children and far below adult immunization goals.…”

Section: Discussionmentioning

confidence: 99%

Vaccination Attitudes Among Patients with Cancer Receiving Chemotherapy.

Akın¹,

Dizdar²,

Özışık³

et al. 2016

UHOD

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Immunization against vaccine preventable diseases is an essential but mostly overlooked issue in oncology practice. We aimed to investigate the utilization of adult immunization recommendations and the perception of the patients with cancer receiving chemotherapy on immunization. A 15-item questionnaire about immunization in adults with cancer diagnosis was administered to patients with various cancers treated in daycare chemotherapy unit of Hacettepe University Cancer Institute. Total of 229 patients completed the survey. Fifty-four percent of patients were vaccinated at least once, most commonly against influenza and tetanus over 18 years old. Higher rate of participants was opposed to vaccination of patients with cancer diagnosis compared with those who were opposed to vaccination of healthy adults. Vaccination was never recommended in 93% of the participants. Only 9% of patients (n=21) were shot after cancer diagnosis. There was a strong association between doctor's advice and vaccination status. Twelve of 15 patients (80%) who were recommended to be vaccinated did so whereas only 9 of 214 remaining patients (4.2%) were vaccinated. Among those not vaccinated after diagnosis of cancer, most frequent reason was; not recommended by the doctor. Neither vaccination rates nor perceptions on adult immunization differed by age, gender, marital status, presence of co-morbidity or type of cancer. Among adult patients with cancer and receiving chemotherapy, immunization rates were found to be very low. Main reason was the lack of recommendation by the primary physician involved in the treatment, mostly oncologist. Awareness on this issue in physicians, particularly oncologists, may increase vaccination rates. Keywords: Adult immunization, Vaccine preventable disease, Cancer chemotherapy ÖZET Kemoterapi Alan Kanser Hastalarının Aşı DavranışlarıÖnlenebilir hastalıklara karşı aşılanma onkoloji pratiğinde ihmal edilen bir konudur. Bu çalışmada kemoterapi alan kanser hastalarının erişkin aşılanması ile ilgili görüş ve algılarını, düşük aşılanma oranlarının nedenlerini araştırmayı amaçladık. Hacettepe Üniversitesi Onkoloji Hastanesi ayaktan tedavi ünitesinde çeşitli kanser tanıları ile kemoterapi almakta olan erişkin hastalara, erişkin aşılanması ile ilgili 15 sorudan oluşan bir anket uygulandı. Toplam 229 hasta anketi tamamladı. Hastaların %74,7'si erişkinlerin de aşılanması gerektiğini düşünmekteydi. En sık influenza ve tetanos aşısı olmak üzere hastaların %54'ü 18 yaşından sonra en az bir defa aşılanmıştı. Katılımcıların %16,6'sı erişkinlerin aşılamasına karşıydı, daha yüksek oranda bir bölümü ise kanserli hastaların aşılanmasına karşı olduklarını belirtti. Hastaların %93'üne kanser tanısı aldıktan sonra hiç aşı önerilmemişti. Sadece 21 hastanın (%9) tanı sonrası aşı yaptırdığı anlaşılırken en sık influenzaya karşı aşılanma görüldü. Doktor önerisi ve aşılanma durumu arasında anlamlı bir ilişki tespit edildi. Kendisine onkoloğu tarafından aşı önerilen 15 hastanın 12'si(%80) aşılanırken, önerilmeyen 214 hastadan sad...

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Section: Discussionmentioning

confidence: 99%

Vaccination Attitudes Among Patients with Cancer Receiving Chemotherapy.

Akın¹,

Dizdar²,

Özışık³

et al. 2016

UHOD

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“…Although concerns have been raised regarding the efficacy of vaccination in patients with malignant disease, studies demonstrate that patients with cancer-including those treated with chemotherapy-remain able to respond to vaccination and that influenza immunisation in this group reduces mortality [3,4]. Side-effects of both influenza and pneumococcal vaccines are mild, and similar to those experienced by the general population [3,[5][6][7]. Consequently, the UK Department of Health (DH) and the US Center for Disease Control (CDC) recommend that in the absence of contraindications, patients planned for cytotoxic therapy should be vaccinated against both S.pneumoniae and influenza [8,9].…”

Section: Introductionmentioning

confidence: 99%

Vaccination of chemotherapy patients—effect of guideline implementation

Toleman

Herbert

McCarthy

et al. 2015

Support Care Cancer

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156 wordsManuscript 1415 words 2 Abstract Purpose: Despite substantial morbidity and mortality of influenza and pneumococcal infections in cancer patients treated with chemotherapy, vaccination against both illnesses is infrequent. We evaluated the impact of implementation of clinical guidelines on vaccination of chemotherapy patients treated in our institute. Methods:Prospective audit before (2012) and after (2013)(2014)) the introduction of immunisation guidelines for chemotherapy patients in a UK tertiary cancer centre.Results: Guideline implementation was associated with a significant increase in the rate of pneumococcal vaccination compared to the 2012 baseline (47% vs. 25%, P=0.0018), though this was not sustained the following year (34%, P =0.13 vs. baseline). Influenza vaccine coverage was high (~70%) throughout. There was a marked disparity between patients aged ≤65 and those >65 years in the rate of pneumococcal vaccination in both 2013 and 2014 (38% vs. 68% and 17 vs. 53%, respectively, both P<0.001), and, to a lesser extent, in the rate of influenza vaccination in the same period (64 vs. 82%, P<0.1, and 63% vs. 85%, P=0.009 respectively). Conclusions:The implementation of clinical vaccine guidelines was associated with a significant increase in pneumococcal vaccination, though continued effort appears required to deliver persistent improvement. Initiatives to increase vaccination uptake in patients aged ≤65 are merited.

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“…A promising method for reducing the risk of influenza infection is vaccination. Therefore, various guidelines, including those described by the Center for Disease Control and Prevention, recommend the influenza vaccination, especially in cancer patients (3). However, vaccination coverage is still low among cancer patients (4).…”

Section: Introductionmentioning

confidence: 99%

A prospective study on the efficacy of two-dose influenza vaccinations in cancer patients receiving chemotherapy

Yukitoshi

Yakushijin

Nomura

et al. 2016

Japanese Journal of Clinical Oncology

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Objective: Cancer patients receiving chemotherapy are at risk of acquiring influenza infections. Twodose vaccination is a proposed strategy for increasing vaccination efficacy; however, this has yet to be confirmed in this population. The purpose of this study was to clarify the efficacy and safety of this strategy. Methods: We conducted a multicentre prospective study on a two-dose vaccination regimen in cancer patients receiving chemotherapy. Second vaccinations were performed in patients who did not respond to all three viral strains after the first vaccination. Serum haemagglutination inhibition titres were measured to determine the patients' immunological response, 2 weeks prior to the first vaccination, 3-5 weeks after each vaccination, and at the end of the influenza season. Results: We enrolled 109 patients, including 70 with solid tumours, 36 with haematological malignancies, and 3 with both cancer types. Among the total patients, the proportion of patients with protective titres against the three viral strains increased significantly from 3 to 27% (P < 0.01) following vaccination. Among the 79 patients who received a second vaccination, the proportion of those with protective titres against the individual strains increased by 10% (H1N1), 8% (H3N2), and 3% (B) compared with after the first vaccination. Serious adverse events were not observed. Conclusions: We recommend influenza vaccinations for cancer patients, including those receiving chemotherapy. Also, the additional benefit of the second vaccination may be limited.

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Influenza vaccines in immunosuppressed adults with cancer

Cited by 37 publications

References 59 publications

Vaccination Attitudes Among Patients with Cancer Receiving Chemotherapy.

Vaccination Attitudes Among Patients with Cancer Receiving Chemotherapy.

Vaccination of chemotherapy patients—effect of guideline implementation

A prospective study on the efficacy of two-dose influenza vaccinations in cancer patients receiving chemotherapy

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