Survivorship: Immunizations and Prevention of Infections, Version 2.2014

Abstract

Cancer survivors are at an elevated risk for infection because of immune suppression associated with prior cancer treatments, and they are at increased risk of complications from vaccine-preventable diseases. This section of the NCCN Guidelines for Survivorship provides recommendations for the prevention of infections in survivors through education, antimicrobial prophylaxis, and the judicious use of vaccines. These guidelines provide information about travel and gardening precautions and safe pet care/avoidance of zoonosis, and include detailed recommendations regarding vaccinations that should be considered and encouraged in cancer and transplant survivors.

Cancer recurrence and mortality after pediatric heart transplantation for anthracycline cardiomyopathy: A report from the Pediatric Heart Transplant Study (PHTS) group

“…Exposure to chemotherapy prior to solid organ transplant may have profound long‐term effects on immune function . These changes may impact the immune response to various pathogens while receiving immunosuppressive therapy after transplantation, leading to an increased incidence of serious infection, including those from vaccine‐preventable diseases . Additional factors, such as induction therapy, may contribute to susceptibility to infection, although no difference in rates of induction therapy was seen between the ACM and DCM groups in the matched cohort ( P ‐value .2) (Table ).…”

Infection-related hospitalizations in breast cancer patients: Risk and impact on prognosis

“…From a clinical perspective, the adverse effect of treatment including chemotherapy needs to be balanced against the survival benefit, with recent trial data showing a ~30% reduction in 10-year mortality with even moderate chemotherapy regimens 36 . Moreover, short-term prevention of infection-related hospitalizations is challenging in an immunocomprised host, although several strategies have been proposed for infectious disease prevention in chemotherapy-treated patients including immunizations and simple hygiene measures 37,38 . Apart from chemotherapy, we identified several patient, tumor and treatment-related risk factors, and this information may aid in the development of tailored, preventive strategies.…”

Vaccination Attitudes Among Patients with Cancer Receiving Chemotherapy.

“…1,2 Several international authorities including Infectious Diseases Society of America (IDSA), United States Advisory Committee on Immunization Practices (ACIP), Centers for Diseases Control and Prevention (CDC), and National Comprehensive Cancer Network (NCCN) have immunization recommendations for cancer patients under the heading of immunosuppression. 3,4 However, real life immunization rates are low, far behind the success in pediatric immunization rates. In the US, for example, about 68% of those over 65 year of age were vaccinated for influenza in 2012 while Tdap (tetanus, diphtheria, acellular pertussis) vaccination rate among adults aged 19-64 years was only 15.6%, HPV vaccination rate among women aged 19-26 years for 1 or more doses was 34.5%.…”