Abstract
Although annual influenza(flu) vaccination is recommended for patients(pts) in designated high-risk categories, little data exist to support these recommendations in pediatric pts. We prospectively followed a group of oncology pts (OP) on chemRx or off Rx for <1. who were not immunized against flu during 2 flu seasons to determine their relative risk of infection and complications compared with matched sibling control (SC) and community control(CC) groups. Results of culture & serology data (episodes/patient seasons) show a higher occurrence of flu in the OP group(33%) than in the SC(22%) or the CC groups (14% p=.01 chi-sq). A “protective” preseason titer of≥1:32 did not prevent flu in 20% of the OP group compared with 4% of the SC and 2% of the CC groups(p .02). No significant differences were noted in duration of reported symptoms between groups and clinical complications occurred too infrequently to analyze. 2/18(11%) of the culture ⊕ OP group were hospitalized during their illness and an additional 1/18 had a nosocomial infection. None of the control children were hospitalized. We conclude that OP's are at greater risk of acquiring flu than are normal children. The duration of their symptoms appears similar to that in normal children but hospitalization may accompany infection more frequently. A preseason titer of ≥1:32, often used as a marker of successful immunization in flu vaccine trials, was poorly protective in the OP group but was protective in controls. Our findings have significant implications for vaccination recommendations and suggest the need for a clinical efficacy trial of the flu vaccine.
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Kempe, A., Hall, C., Macdonald, N. et al. INFLUENZA IN CHILDREN WITH CANCER. Pediatr Res 21 (Suppl 4), 258 (1987). https://doi.org/10.1203/00006450-198704010-00544
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DOI: https://doi.org/10.1203/00006450-198704010-00544