Observational study of vaccination in cancer patients: How can vaccine coverage be improved?

Anna Monier · Mathieu Puyade · Maria Pilar Gallego Hernanz · Patrick Bouchaert · Xavier P Leleu · J.M. Tourani +2 more

38 citations0/0 files storedMédecine et Maladies Infectieuses

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Vaccine Coverage and Hesitancy Immunotherapy and Immune Responses Neutropenia and Cancer Infections

Abstract

BACKGROUND: Chemotherapy increases the risk of infections, often severe, and some of them are vaccine-preventable infections. We aimed to assess vaccination coverage and associated factors in oncology and hematology patients. METHODS: Consecutive adult patients followed in a French university hospital for hematological malignancy or solid cancer voluntarily completed an anonymous questionnaire in September and October 2016. It included questions on underlying disease, chemotherapy, flu, and pneumococcal vaccination uptakes, and attitudes toward vaccination. Factors associated with vaccination uptake were assessed by multivariate logistic regression. RESULTS: The response rate was 41.9% (N=671) among 1,600 questionnaires distributed; 232 patients had underlying hematological malignancy and 439 had solid cancer. Half of the patients were aged over 65 years. Chemotherapy was ongoing or discontinued for less than one year in 74.7% of patients. In patients aged <65 years undergoing chemotherapy, flu vaccination rate was 19.9% whereas patients aged >65 years had coverage of 47%. Pneumococcal vaccine uptake was 7.3%. However, 64.7% of patients were favorable to vaccination. Vaccine uptake was associated with age >65 years (OR 4.5 [2.9-7.0]), information about vaccination delivered by the family physician (OR 12.9 [5.5-30.1]), follow-up in hematology unit (OR 2.0 [1.3-3.1]), and positive opinion about vaccination (OR 2.0 [1.3-3.1]). CONCLUSION: Despite specific recommendations regarding immunocompromised patients, anti-pneumococcal and flu vaccinations were rarely conducted, even in elderly patients. Targeted information campaigns to family physicians, oncologists, and patients should be implemented to improve vaccine coverage in patients with underlying malignancies.

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References

1996Factors associated with influenza and pneumococcal vaccination behavior among high-risk adults 2016Vaccination of special populations: Protecting the vulnerable 1992Influenza Vaccination 2015Attitude, knowledge and factors associated with influenza and pneumococcal vaccine uptake in a large cohort of patients with secondary immune deficiency 2008Low influenza vaccination rate among patients receiving chemotherapy for cancer

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2022Understanding predictors of pneumococcal vaccine uptake in older adults aged 65 years and older in high-income countries across the globe: A scoping review 2022Vaccination Coverage among Immunocompromised Patients in a Large Health Maintenance Organization: Findings from a Novel Computerized Registry 2021Influenza vaccination uptake and attitudes among adult cancer patients in Japan: a web-based questionnaire survey before the 2020/2021 season 2023Impact of pharmacist-led educational intervention on pneumococcal vaccination rates in cancer patients: a randomized controlled study

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