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Vaccination of chemotherapy patients—effect of guideline implementation

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

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Acknowledgments

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.

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Authors and Affiliations

  1. Oxford Cancer Centre, Churchill Hospital, University of Oxford, Old Road, Headington, Oxford, OX3 7LE, UK

    Michelle S. Toleman, Katharine Herbert & David N. Church

  2. Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK

    Noel McCarthy

  3. The Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, OX3 7BN, UK

    David N. Church

Authors
  1. Michelle S. Toleman
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  2. Katharine Herbert
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  3. Noel McCarthy
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  4. David N. Church
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Corresponding author

Correspondence to David N. Church.

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Conflict of interests

The authors declare that they have no competing interests.

Funding

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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Toleman, M.S., Herbert, K., McCarthy, N. et al. Vaccination of chemotherapy patients—effect of guideline implementation. Support Care Cancer 24, 2317–2321 (2016). https://doi.org/10.1007/s00520-015-3037-6

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  • DOI: https://doi.org/10.1007/s00520-015-3037-6

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