Survivors of childhood cancer: An Australian audit of vaccination status after treatment

Authors

  • Nigel W. Crawford MBBS,

    Corresponding author
    1. NHMRC Centre for Clinical Research Excellence in Child and Adolescent Immunization, Parkville, VIC, Australia
    2. Murdoch Childrens Research Institute, Parkville, VIC, Australia
    3. Immunization Service, Department of General Medicine, Royal Children's Hospital (RCH), Melbourne, Australia
    4. Department of Paediatrics, University of Melbourne, Melbourne, Australia
    • Paediatrician, NHMRC CCRE in Childhood and Adolescent Immunization, SAEFVIC-Immunization Adverse Events Surveillance Unit, Department of General Medicine, 5th Floor, AP1 Building, Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Road, Parkville, VIC 3052, Australia.
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  • John A. Heath PhD,

    1. Murdoch Childrens Research Institute, Parkville, VIC, Australia
    2. Department of Paediatrics, University of Melbourne, Melbourne, Australia
    3. Children's Cancer Centre, RCH, Melbourne, Australia
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  • David Ashley PhD,

    1. Murdoch Childrens Research Institute, Parkville, VIC, Australia
    2. Department of Paediatrics, University of Melbourne, Melbourne, Australia
    3. Children's Cancer Centre, RCH, Melbourne, Australia
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  • Peter Downie MBBS,

    1. Children's Cancer Centre, RCH, Melbourne, Australia
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  • Jim P. Buttery MBBS

    1. NHMRC Centre for Clinical Research Excellence in Child and Adolescent Immunization, Parkville, VIC, Australia
    2. Murdoch Childrens Research Institute, Parkville, VIC, Australia
    3. Immunization Service, Department of General Medicine, Royal Children's Hospital (RCH), Melbourne, Australia
    4. Department of Paediatrics, University of Melbourne, Melbourne, Australia
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Abstract

Background

Survivors of childhood and adolescent cancer are at risk of vaccine preventable diseases and are recommended to receive booster vaccinations post-chemotherapy. The aim of this study was to describe the compliance of post-chemotherapy revaccination of childhood cancer survivors relative to current Australian guidelines.

Procedures

A multi-faceted retrospective review of childhood cancer survivors at the Royal Children's Hospital, Melbourne, Australia was undertaken. Immunisation status was reviewed through four sources: (1) hospital records; (2) telephone survey of consenting participants; (3) Australian Childhood Immunization Register (ACIR); and (4) family practitioners immunisation records. Participants were 0–18 years, and at least 6 months post-treatment for their cancer.

Results

The study was conducted between March and September 2006. Eighty-nine patients with a median age at diagnosis of 5.3 years were included, 56% of patients had a diagnosis of leukaemia and 44% solid tumours. The median duration since completion of therapy was 3.1 years. Reviewing all sources, 39% (35/89) of participants had no evidence of booster vaccinations post-completion of therapy. Younger age (P = 0.001), and those diagnosed with leukaemia (P = 0.04) were more likely to have received at least one booster vaccine. Forty-seven percent (42/89) had received at least one influenza vaccination.

Conclusion

This study highlights poor compliance with current guidelines for re-vaccination in survivors of childhood and adolescent cancer. More evidence is required and these re-vaccination guidelines need to take into account treatment intensity. Multi-component strategies are essential to ensure protection from vaccine preventable diseases in this population. Pediatr Blood Cancer 2010; 54:128–133. © 2009 Wiley-Liss, Inc.

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