Vaccination in pediatric cancer survivors: Vaccination rates, immune status, and knowledge regarding compliance

Abstract

Background Vaccination recommendations for childhood cancer survivors are ambiguous. Limited data exist on vaccination rates and patient/caregiver knowledge of vaccination postchemotherapy. Procedure A single‐institution study of childhood cancer survivors treated from 1996 to 2018. Study included a retrospective chart review assessing patient's vaccination status, survey of patient's/caregiver's knowledge/beliefs regarding vaccination postchemotherapy, and assessment of immunoglobulin titers. Results A total of 120 patient charts were included. Vaccination records were available for 82% (98/120) of patients, 57% (56/98) were up to date with vaccinations before chemotherapy, and 83% (81/98) received vaccinations after chemotherapy. Children who resumed vaccination postchemotherapy were younger at cancer diagnosis compared to those who did not resume vaccination (2 vs 4 years, P < .02). Median time since chemotherapy was higher in vaccinated versus unvaccinated patients (107 vs 60 months, P < .02). Immunoglobulin titers were assessed in 27 patients, and 74% (20/27) were not immune to one or more infections tested. Lack of immunity to pneumococcal strains was the most common. There was no difference in median age at diagnosis or time since chemotherapy completion in immune versus nonimmune patients. In 33 surveyed patients/caregivers, 33% (11/33) were not advised about resuming vaccinations postchemotherapy. Over one‐third (12/33) of respondents were concerned about vaccination safety after chemotherapy, although 88% (29/33) agreed they would vaccinate if recommended by their pediatrician/pediatric oncologist. Conclusions Most childhood cancer survivors resume vaccinations postchemotherapy. Considerable variability exists in vaccination timing after chemotherapy. Pediatric oncologists play a central role in educating patients/pediatricians about vaccination recommendations postchemotherapy.

Current vaccination status and safety of children with peripheral neuroblastoma in the real-world

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Missed opportunities for concomitant HPV vaccination among childhood cancer survivors

“…The HPV vaccine is indicated for immunocompromised individuals and the Children's Oncology Group (COG) recommends resuming vaccines 3–6 months post‐therapy and 6–12 months for live vaccines, suggesting that education for providers and caregivers may be necessary for increasing HPV vaccination uptake for survivors 27,33 33 4 …”

A Mannose-Modified Lipid Calcium Phosphate Nanoparticle Vaccine Increased the Anti-Tumor Immune Response by Modulating the Tumor Microenvironment

“…Studies [214][215][216][217][218][219][220] have shown that the vaccine can activate the body's immune system, promote the expression and recognition of tumor-associated antigens, and trigger a specific immune response against tumor cells. Through mannose modification, the vaccine can be more effectively taken up by antigen-presenting cells and improve its efficiency of antigen delivery in the lymph nodes, further activating immune cells such as dendritic cells and T cells and enhancing the potential of the immune response [221].…”