Observational study of vaccination in cancer patients: How can vaccine coverage be improved? - 04/05/20
Étude observationnelle sur la vaccination chez les patients atteints de cancer : comment améliorer la couverture vaccinale ?
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Highlights |
• | Patients presenting with cancer should benefit from vaccines as they are exposed to a heightened risk of invasive pneumococcal diseases (IPD) and influenza illness, leading to an increased risk of morbi-mortality. |
• | Cancer patients are under vaccinated against the two main frequent and threatening diseases (IPD and the flu) with vaccination coverage of 7.2% and 28.6%, respectively. |
• | Factors associated with appropriate vaccination in oncology and hematology include age ≥65 years, information received from family physicians, being treated for an hematological malignancy, and having a positive opinion about vaccination. |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Immunocompromised host, Cancer, Vaccination
Plan
Vol 50 - N° 3
P. 263-268 - mai 2020 Retour au numéro
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