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Evidence summaries

Influenza Vaccination in Children Being Treated with Chemotherapy for Cancer

Paediatric oncology patients receiving chemotherapy appear to be able to generate an immune response to the influenza vaccine. However, it remains unclear whether this immune response protects them from influenza infection or its complications. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 1 RCT and 9 CCTs with a total of 770 subjects. None of the included studies reported on clinical outcomes. All included studies reported on influenza immunity and adverse reactions to vaccination. In five studies, immune responses to influenza vaccine were compared in 272 children on chemotherapy with 166 children not on chemotherapy. In four studies, responses to influenza vaccine were assessed in 236 children on chemotherapy compared with responses in 142 healthy children.

The measures used to assess immune responses were: a four-fold rise in antibody titre after vaccination, development of haemagglutination inhibition (HI) titre > 32, and pre- and post-vaccination geometric mean titres (GMT). Immune responses in children receiving chemotherapy were consistently weaker (four-fold rise of 38% to 65%) than in those children who had completed chemotherapy (50% to 86%) and in healthy children (53% to 89%). Concerning adverse effects, 391 paediatric oncology patients received influenza vaccine and the side effects described were mild local reactions and low grade fever. No life-threatening or persistent adverse effects were reported.

Comment: The evidence is downgraded by study quality (inadequate or unclear allocation concealment).

    References

    • Goossen GM, Kremer LC, van de Wetering MD. Influenza vaccination in children being treated with chemotherapy for cancer. Cochrane Database Syst Rev 2013;(8):CD006484. [PubMed]

Primary/Secondary Keywords