title: Immunogenicity of vaccination against influenza, Streptococcus pneumoniae and Haemophilus influenzae type B in patients with multiple myeloma.
abstract: Vaccination against influenza and Streptococcus pneumoniae is recommended for elderly and immunocompromised individuals. However, there is little information concerning the efficacy of vaccination in specific groups of patients. In this study, 52 patients underwent vaccination against influenza, S. pneumoniae and Haemophilus influenzae type b (Hib) as they attended hospital outpatient clinics. Serum was analysed prior to vaccination and 4-6 weeks afterwards. Antibody titres against S. pneumoniae and Hib were compared with reference values corresponding to the geometric mean titres of a healthy UK population. For influenza vaccination, haemagglutination inhibition (HI) titres were measured against three inactivated strains; a titre of > or = 1/40 was considered protective. No patient had protective titres to all three antigens prior to vaccination and 41 patients (85%) had titres < 1/40 to all 3 strains. Post vaccination only 9/48 patients (19%) achieved protective antibody titres. Resistance to S. pneumoniae and response to Pneumovax II was also poor: prevaccination, 45 patients (93%) had suboptimal antibody titres and in 26/43 patients (61%) titres remained low post vaccination. Resistance to Hib and response to vaccination was comparable with the healthy adult UK population. These results question the practice of routine influenza and pneumococcal vaccination in myeloma patients.
authors.affiliation: Christie Hospital NHS Trust, Withington, Manchester, UK.
authors.forename: J D
authors.initials: JD
authors.lastname: Robertson
authors.forename: K
authors.initials: K
authors.lastname: Nagesh
authors.forename: S N
authors.initials: SN
authors.lastname: Jowitt
authors.forename: M
authors.initials: M
authors.lastname: Dougal
authors.forename: H
authors.initials: H
authors.lastname: Anderson
authors.forename: K
authors.initials: K
authors.lastname: Mutton
authors.forename: M
authors.initials: M
authors.lastname: Zambon
authors.forename: J H
authors.initials: JH
authors.lastname: Scarffe
mesh_terms: D000328:Adult; D000368:Aged; D000917:Antibody Formation; D005260:Female; D006192:Haemophilus Infections / Q000517:prevention & control*; D018073:Haemophilus Vaccines / Q000276:immunology*; D006193:Haemophilus influenzae / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007252:Influenza Vaccines / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology*; D011008:Pneumococcal Infections / Q000276:immunology / Q000517:prevention & control*; D013296:Streptococcus pneumoniae / Q000276:immunology; D014611:Vaccination
chemical_list: D018073:Haemophilus Vaccines; D007252:Influenza Vaccines