The benefit of influenza vaccination after bone marrow transplantation

Abstract

Summary:Influenza vaccine is recommended yearly for recipients after the sixth month of BMT. Although a higher risk of complications of influenza is expected to occur in BMT patients, no study has addressed the clinical efficacy of influenza vaccination in this setting. Focusing on the clinical benefits of influenza vaccination, we evaluated the risk factors for influenza infection in a cohort of 177 BMT recipients followed up for 1 year. Influenza was diagnosed in 39 patients. Multivariate analyses showed that seasonal exposure and more aggressive conditioning regimens were independently associated with increased risk for influenza. Influenza vaccination and steroid use showed a protective role. Of the 43 patients who had received BMT longer than 6 months, 19 were vaccinated (compliance rate ¼ 44.2%) and vaccine efficacy was 80%. We conclude that influenza vaccination plays an important role in protecting BMT recipients against influenza and all efforts should be made to ensure good compliance with vaccination. Bone Marrow Transplantation (2005) 36, 897-900.

Effectiveness of the Brazilian influenza vaccination policy, a systematic review

“…Among health professionals, two surveys conducted in two of the leading university hospitals in the country presented coverage of 19.7% and 34.4% 4,33 . In the same institutions, vaccine coverage among transplant patients varied between 44.2% (bone marrow transplant) and 0% (kidney) 5,25 . The other ten studies analyzed vaccine coverage among the senior population.…”

“…The mean number of ILI episodes reported during the year was 1.5 among vaccinated subjects and 2.25 among non-vaccinated (p = 0.019) 23 . Another study analyzed the effectiveness of the vaccination of transplant patients 25 .…”

“…Studies using an individualized design: only two of the recovered studies analyzed the Brazilian vaccination strategy using an individuallybased design 23,25 . A cross-sectional study conducted early in the course of the initiative in 2000, targeted the elderly clientele of the largest university hospital complex in the country.…”

“…The other study evaluated the effectiveness of the influenza vaccine in bone marrow transplant recipients, using a laboratory which confirmed influenza as the outcome variable. Vaccine effectiveness was estimated at 80% 25 . Morbidity and mortality ecological studies addressing the effectiveness of influenza vaccine campaigns have produced conflicting results.…”

Pertussis: should we vaccinate post transplant?

“…A recent randomised study demonstrated that influenza vaccination plays an important role in protecting BMT recipients against influenza with an efficacy of 80%, emphasising the importance of good compliance with vaccination. 8 The rising trend in the incidence and localised outbreaks of pertussis, as described above, suggests that the current vaccination schedule for infants may not be sufficient to provide herd immunity. Data from older adults suggest considerable morbidity in immunocompetent individuals owing to bordetella pertussis.…”