title: Immunisation practices of paediatric oncology and shared care oncology consultants: a United Kingdom survey.
abstract: BACKGROUND
  In March 2002, the Royal College of Paediatrics and Child Health (RCPCH) introduced guidelines for re-immunisation of children after completion of standard-dose chemotherapy and after haematopoietic stem cell transplant (HSCT).
  
  
  OBJECTIVE
  To ascertain whether these guidelines form standard unit policy by undertaking a survey of UK paediatric principal treatment centre (PTC) consultants and shared care (SC) consultants.
  
  
  METHODS
  In October 2008, a link to an on-line anonymised survey was sent by e-mail to all UK PTC consultants in Children's Cancer and Leukaemia Group (CCLG) centres and to SC consultants linked to eight of these centres.
  
  
  RESULTS
  Responses were received from 55 PTC consultants (representing all 21 CCLG centres) and 54 SC consultants. In accordance with the RCPCH guidelines, most PTC and SC consultants recommend initiating re-immunisation at 6 months after completion of standard-dose chemotherapy (99/105, 94.3%). Re-immunisation at the recommended time after HSCT for each transplant type was reported by 93-100% of respondents. Pneumococcal conjugate vaccine (PCV) was recommended after chemotherapy by 58.3% (35/60) of respondents and by 51.7% (30/58) after HSCT. There were distinct differences between PTC and SC consultants in their choice of varicella (VZV) post-exposure prophylaxis.
  
  
  CONCLUSIONS
  There is a high level of stated compliance with RCPCH guidelines. Recommendations for PCV after chemotherapy and HSCT were lower than expected. This may reflect the absence of specific guidelines after chemotherapy but not in HSCT patients where guidelines do exist. Variation in VZV post-exposure prophylaxis suggests further studies are required.
authors.affiliation: Division of Child Health, St. George's University of London, London, UK. jbate@sgul.ac.uk
authors.forename: Jessica
authors.initials: J
authors.lastname: Bate
authors.forename: Soonie R
authors.initials: SR
authors.lastname: Patel
authors.forename: Julia
authors.initials: J
authors.lastname: Chisholm
authors.forename: Paul T
authors.initials: PT
authors.lastname: Heath
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007117:Immunization, Secondary / Q000706:statistics & numerical data*; D008495:Medical Oncology / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000628:therapy; D010372:Pediatrics / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D006113:United Kingdom
chemical_list: D000970:Antineoplastic Agents