Why coverage of influenza vaccine is not enough in patients receiving chemotherapy?

DEAR EDITOR,

Instead of strict recommendations of experts of doing vaccination in chemotherapy patients, they may not be aware of its necessity, except to be encouraged by their responsible healthcare workers. As it is clear that morbidity and mortality of influenza is high in immunocompromised patients.12 According to some reports, mortality rate of influenza infection can reach 9% among oncology patients.3 Vaccination against influenza is recommended in immunosuppressed patients, including those receive anticancer chemotherapy.4 Absence of immunization commands, particularly against influenza, endangers the quality of life in patients with cancer.3 Generally, although patients with cancer respond positively to vaccination, the utility of influenza vaccination is very low in this population.

The purpose of this study is to evaluate if the influenza vaccine coverage in oncology patients under chemotherapy treatment is enough to guarantee prevention during the season. We also tried to investigate the factors influencing coverage rate. Between January and March 2010, we performed a prospective, monocentric study in 100 patients with median age of 47 years (range 16–79). A standardized form was given to all cancer patients receiving chemotherapy in our department. The median time to receive chemotherapy was 14 months (range out of 1–180) among the patients with colorectal (30%), sarcoma (6%), leukemia (18%), and breast and ovarian (11%) cancers.

Only nine patients (9%) had received influenza shots: Chemotherapy was the reason for shot in only 44.4% of those who were vaccinated, while 55.6% of remaining people got the vaccine for some other reasons. No relationship was found between the vaccination rate and age. A similar study published on 2008 reported 30% of coverage which is pretty much more in our study.5

Although cancer patients often care about their own health, but health workers may neglect to recommend influenza vaccine that may be the leading cause of low vaccination rate. It is important to encourage patients with cancer to get a flu shot before the season is going off. In addition, fear of side effects is among the factors that crash coverage of vaccination in this group. According to the immunologic status of oncology patients, more attention is required to make their coverage full especially in those undergoing chemotherapy.