Survivors of childhood cancer: an Australian audit of vaccination status after treatment.
BACKGROUND
Survivors of childhood and adolescent cancer are at risk of vaccine preventable diseases and are recommended to receive booster vaccinations post-chemotherapy. The aim of this study was to describe the compliance of post-chemotherapy revaccination of childhood cancer survivors relative to current Australian guidelines.


METHODS
A multi-faceted retrospective review of childhood cancer survivors at the Royal Children's Hospital, Melbourne, Australia was undertaken. Immunisation status was reviewed through four sources: (1) hospital records; (2) telephone survey of consenting participants; (3) Australian Childhood Immunization Register (ACIR); and (4) family practitioners immunisation records. Participants were 0-18 years, and at least 6 months post-treatment for their cancer.


RESULTS
The study was conducted between March and September 2006. Eighty-nine patients with a median age at diagnosis of 5.3 years were included, 56% of patients had a diagnosis of leukaemia and 44% solid tumours. The median duration since completion of therapy was 3.1 years. Reviewing all sources, 39% (35/89) of participants had no evidence of booster vaccinations post-completion of therapy. Younger age (P = 0.001), and those diagnosed with leukaemia (P = 0.04) were more likely to have received at least one booster vaccine. Forty-seven percent (42/89) had received at least one influenza vaccination.


CONCLUSIONS
This study highlights poor compliance with current guidelines for re-vaccination in survivors of childhood and adolescent cancer. More evidence is required and these re-vaccination guidelines need to take into account treatment intensity. Multi-component strategies are essential to ensure protection from vaccine preventable diseases in this population.
NHMRC Centre for Clinical Research Excellence in Child and Adolescent Immunization, Parkville, VIC, Australia. nigel.crawford@rch.org.au
Nigel W
NW
Crawford
John A
JA
Heath
David
D
Ashley
Peter
P
Downie
Jim P
JP
Buttery
D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000379:methods*; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D008297:Male; D008485:Medical Audit; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology*; D010349:Patient Compliance; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*