Vaccination of chemotherapy patients—effect of guideline implementation
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Despite substantial morbidity and mortality of influenza and pneumococcal infections in cancer patients treated with chemotherapy, vaccination against both illnesses is infrequent. We evaluated the impact of implementation of clinical guidelines on vaccination of chemotherapy patients treated in our institute.
We performed a prospective audit before (2012) and after (2013–2014) the introduction of immunisation guidelines for chemotherapy patients in a UK tertiary cancer centre.
Guideline implementation was associated with a significant increase in the rate of pneumococcal vaccination compared to the 2012 baseline (47 vs. 25 %, P = 0.0018), though this was not sustained the following year (34 %, P = 0.13, vs. baseline). Influenza vaccine coverage was high (∼70 %) throughout. There was a marked disparity between patients aged ≤65 and those >65 years in the rate of pneumococcal vaccination in both 2013 and 2014 (38 vs. 68 % and 17 vs. 53 %, respectively, both P < 0.001), and, to a lesser extent, in the rate of influenza vaccination in the same period (64 vs. 82 %, P < 0.1, and 63 vs. 85 %, P = 0.009, respectively).
The implementation of clinical vaccine guidelines was associated with a significant increase in pneumococcal vaccination, though continued effort appears required to deliver persistent improvement. Initiatives to increase vaccination uptake in patients aged ≤65 are merited.
KeywordsInfluenza Streptococcus pneumoniae Vaccination Immunisation Chemotherapy Cancer
The authors would like to thank Dr. Andrew Pollard and Dr. Tony Berendt for their input into the local immunisation guidelines, and the staff of the Oxford Cancer Centre Day Treatment Unit for distributing questionnaires to patients.
Compliance with ethical standards
Conflict of interests
The authors declare that they have no competing interests.
DC is a recipient of an Academy of Medical Sciences/Health Foundation Clinician Scientist award and has received research funding from the Oxford Cancer Research Centre for other projects. MT and KH receive research funding from the Wellcome Trust. NM receives funding from the UK National Institute for Health Research. No funding was obtained to conduct this audit.
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