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Bonanni P, Maio M, Beretta GD, Icardi G, Rossi A, Cinieri S. Improving Influenza Vaccination Coverage in Patients with Cancer: A Position Paper from a Multidisciplinary Expert Group. Vaccines (Basel) 2024; 12:420. [PMID: 38675802 PMCID: PMC11053698 DOI: 10.3390/vaccines12040420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Patients with cancer can be immunocompromised because of their disease and/or due to anticancer therapy. In this population, severe influenza virus infections are associated with an elevated risk of morbidity and mortality. Influenza vaccination is therefore highly recommended in cancer patients, including those receiving anticancer therapy. However, vaccination coverage remains far below the recommended target for vulnerable subjects. Six specialists in oncology, hematology, immunology, and public health/vaccinology convened with the objective of developing strategies, based on evidence and clinical experience, for improving influenza vaccination coverage in cancer patients. This viewpoint provides an overview of current influenza vaccination recommendations in cancer patients, discusses barriers to vaccination coverage, and presents strategies for overcoming said barriers. New immunization issues raised by the COVID-19 pandemic are also addressed. Future directions include improving public education on influenza vaccination, providing the media with accurate information, improving knowledge among healthcare professionals, improving access to vaccines for cancer patients, co-administration of the influenza and COVID-19 vaccines, increased collaboration between oncologists and other health professionals, increased accessibility of digital vaccination registries to specialists, shared information platforms, and promoting immunization campaigns by healthcare systems with the support of scientific societies.
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Affiliation(s)
- Paolo Bonanni
- Department of Health Sciences, University of Florence, Viale G.B. Morgagni 48, 50134 Florence, Italy;
| | - Michele Maio
- Medical Oncology, Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
- Department of Oncology, Center for Immuno-Oncology, Azienda Ospedaliero Universitaria Senese, 53100 Siena, Italy
| | - Giordano D. Beretta
- Medical Oncology Unit Pescara Hospital, Via Fonte Romana 8, 65124 Pescara, Italy;
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy;
- Hygiene Unit, Ospedale Policlinico San Martino IRCCS Genoa, Largo Benzi 10, 16132 Genoa, Italy
| | - Alessandro Rossi
- Giunta Esecutiva SIMG, Via del Sansovino 172, 50142 Florence, Italy;
| | - Saverio Cinieri
- Medical Oncology and Breast Unit, Ospedale Perrino, S.S. 7 per Mesagne, 72100 Brindisi, Italy;
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van Thiel Berghuijs KM, Kaddas HK, Warner EL, Fair DB, Fluchel M, Knackstedt ED, Verma A, Kepka D, Green AL, Smitherman AB, Draper L, Johnson RH, Kirchhoff AC. Vaccination practices of pediatric oncologists from eight states. BMC Health Serv Res 2023; 23:1215. [PMID: 37932718 PMCID: PMC10629174 DOI: 10.1186/s12913-023-10160-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 10/16/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Vaccinations are a vital part of routine childhood and adolescent preventive care. We sought to identify current oncology provider practices, barriers, and attitudes towards vaccinating childhood and adolescent cancer patients and survivors. METHODS We conducted a one-time online survey distributed from March-October 2018 to pediatric oncologists at nine institutions across the United States (N = 111, 68.8% participation rate). The survey included 32 items about vaccination practices, barriers to post-treatment vaccination, availability of vaccinations in oncology clinic, familiarity with vaccine guidelines, and attitudes toward vaccination responsibilities. Descriptive statistics were calculated in STATA 14.2. RESULTS Participants were 54.0% female and 82.9% white, with 12.6% specializing in Bone Marrow Transplants. Influenza was the most commonly resumed vaccine after treatment (7030%). About 50%-60% were familiar with vaccine guidelines for immunocompromised patients. More than half (62.7%) recommended that patients restart most immunizations 6 months to 1 year after chemotherapy. Common barriers to providers recommending vaccinations included not having previous vaccine records for patients (56.8%) or lacking time to ascertain which vaccines are needed (32.4%). Of participants, 66.7% stated that vaccination should be managed by primary care providers, but with guidance from oncologists. CONCLUSIONS Many pediatric oncologists report being unfamiliar with vaccine guidelines for immunocompromised patients and almost all report barriers in supporting patients regarding vaccines after cancer treatment. Our findings show that further research and interventions are needed to help bridge oncology care and primary care regarding immunizations after treatment.
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Affiliation(s)
| | - Heydon K Kaddas
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA
| | - Echo L Warner
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA
- University of Arizona Cancer Center, Tucson, AZ, 85719, USA
| | - Douglas B Fair
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, 84108, USA
- Primary Children's Hospital, Intermountain Healthcare, Salt Lake City, UT, 84113, USA
| | - Mark Fluchel
- Seattle Children's Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA, 98105, USA
| | - Elizabeth D Knackstedt
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, 84113, USA
| | - Anupam Verma
- Pediatric Specialists of Virginia, Center for Cancer and Blood Disorders, Fairfax, VA, 22031, USA
- Center for Cancer and Blood Disorders, Division of Oncology, Children's National Hospital, Washington DC, 20010, USA
| | - Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA
- College of Nursing, University of Utah, Salt Lake City, UT, 84112, USA
| | - Adam L Green
- Children's Hospital of Colorado/University Colorado, Aurora, CO, 80045, USA
| | - Andrew B Smitherman
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, 27514, USA
| | | | | | - Anne C Kirchhoff
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, 84108, USA
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Pedrazzoli P, Lasagna A, Cassaniti I, Piralla A, Squeri A, Bruno R, Sacchi P, Baldanti F, Di Maio M, Beretta GD, Cinieri S, Silvestris N. Vaccination for seasonal flu, pneumococcal infection, and SARS-CoV-2 in patients with solid tumors: recommendations of the Associazione Italiana di Oncologia Medica (AIOM). ESMO Open 2023; 8:101215. [PMID: 37104930 PMCID: PMC10067463 DOI: 10.1016/j.esmoop.2023.101215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 04/05/2023] Open
Abstract
Patients with cancer have a well-known and higher risk of vaccine-preventable diseases (VPDs). VPDs may cause severe complications in this setting due to the immune system impairment, malnutrition and oncological treatments. Despite this evidence, vaccination rates are inadequate. The Italian Association of Medical Oncology (AIOM) has been involved in vaccination awareness since 2014. Based on a careful review of the available data about the immunogenicity, effectiveness and safety of flu, pneumococcal and anti-SARS-CoV-2 vaccines, we report the recommendations of the Associazione Italiana di Oncologia Medica about these vaccinations in adult patients with solid tumors. AIOM recommends comprehensive education on the issue of VPDs. We believe that a multidisciplinary care model may improve the vaccination coverage in immunocompromised patients. Continued surveillance, implementation of preventive practices and future well-designed immunological prospective studies are essential for a better management of our patients with cancer.
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Affiliation(s)
- P Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Lasagna
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - I Cassaniti
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Squeri
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy; School of Specialization in Medical Oncology, University of Messina, Messina, Italy
| | - R Bruno
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - P Sacchi
- Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Baldanti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Di Maio
- Department of Oncology, University of Turin, Division of Medical Oncology, Ordine Mauriziano Hospital, Turin, Italy
| | - G D Beretta
- Medical Oncology Unit, Santo Spirito Hospital, Pescara, Italy
| | - S Cinieri
- Medical Oncology Division and Breast Unit, Senatore Antonio Perrino Hospital, ASL Brindisi, Brindisi, Italy
| | - N Silvestris
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy
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Chebel R, Labaki C, Farhat M, Kattan J. Safety, efficacy and acceptability of SARS-CoV-2 vaccines in patients with cancer. Future Virol 2021. [PMID: 34249141 PMCID: PMC8246498 DOI: 10.2217/fvl-2021-0072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/11/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Roy Chebel
- Department of Hematology-Oncology, Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
| | - Chris Labaki
- Department of Hematology-Oncology, Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
| | - Maria Farhat
- Department of Hematology-Oncology, Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Department of Hematology-Oncology, Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
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