Work

Impact of Influenza Vaccination on Outcomes of Influenza Infections in Immunocompromised Patients

Year: 2019

Type: article

Abstract: Introduction Patients with cancer are more susceptible to influenza infections than the general population, Hematopoietic Cell Transplant (HCT) recipients in particular. Conflicting data on influenza vaccine effectiveness and a lack of clear recommendations in complex clinical scenarios make the compliance with immunization suboptimal. Methods We conducted a retrospective study and included both HCT and non-HCT recipients with laboratory-confirmed influenza infection during the previous flu season (September 2017- May 2018). We evaluated 365 patients with hematologic malignancies (85), HCT recipients (138), and patients with various solid tumors (142). We analyzed the impact of influenza vaccination on mortality. Results Influenza A/H3N2 was the most common type detected during the past season with a total of 251 (69%) patients affected and half of the patients were hospitalized. Amongst the HCT recipients, more patients had an allogeneic than autologous transplant (56% vs. 44%). When compared to HCT recipients who were vaccinated, non-vaccinated HCT recipients had higher mortality rate (21% vs. 6%, p<0.05) and more died from respiratory failure (17% vs. 5%, p<0.05). When stratifying HCT recipients with or without lymphopenia (lymphocytes count <200) at diagnosis, mortality was higher amongst patients with lymphopenia (26% vs. 6%, p<0.05). Similarly, for patients with hematologic malignancies, the vaccination status was a significant risk factor for mortality (Table). Conclusion Influenza vaccine administered to HCT and non-HCT recipients prior to a flu infection was effective in reducing overall morbidity and mortality associated with this infection. Although protection from influenza infection was suboptimal, we recommend universal vaccination during the flu season to prevent worse outcomes including mortality, especially amongst HCT recipients.

Source: Transplantation and Cellular Therapy

DOI: 10.1016/j.bbmt.2018.12.569

Authors: Lea Sacca, Roy F. Chemaly, Marjorie V. Batista, Ying Jiang, Lynn El Haddad, Ella J Ariza-Heredia

Institutions: The University of Texas Health Science Center at Houston, The University of Texas MD Anderson Cancer Center

Language: English

Topic: Influenza Virus Research Studies

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,650