title: Vaccination adherence in hematopoietic stem cell transplant patients: a pilot study on the impact of vaccination cards and reminder telephone calls.
abstract: BACKGROUND
  The Karmanos Cancer Center Bone Marrow Transplant (KCC BMT) Center updated the vaccination protocol for transplant patients based on joint guidelines recently published by European Bone Marrow Transplantation, Centers for Disease Control, Infectious Diseases Society of America, and the American Society for Bone Marrow Transplantation. The objectives for this study were to determine the impact of vaccination cards and telephone outreach on vaccine adherence and to determine the reasons for missed or delayed vaccinations.
  
  
  METHODS
  Retrospective analysis consisted of autologous and allogeneic hematopoietic stem cell transplant (HSCT) patients at the KCC BMT Clinic who received vaccines based on the guidelines published in 2009. Adherence was calculated as percentage of vaccines missed over the vaccination period.
  
  
  RESULTS
  Overall, 37 of 111 patients (33%) missed at least 1 vaccine set and 29 patients (26%) received 1 set later than recommended. Reasons for missed and delayed vaccines included neutropenia/thrombocytopenia, anticoagulation, active infection, and graft-versus-host complications.
  
  
  CONCLUSIONS
  Current guidelines recommend a complex vaccination schedule for the HSCT recipients, which may lead to difficulties with adherence. Our study shows that missed and delayed vaccinations are common in both autologous and allogeneic HSCT recipients. Methods to improve adherence are needed.
authors.affiliation: Department of Pharmacy, Wayne State University College of Pharmacy and Allied Health, Detroit, Michigan, USA; Karmanos Cancer Center, Detroit, Michigan, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Lerchenfeldt
authors.forename: S M
authors.initials: SM
authors.lastname: Cronin
authors.forename: P H
authors.initials: PH
authors.lastname: Chandrasekar
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001071:Appointments and Schedules; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007115:Immunization Schedule; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology; D010349:Patient Compliance; D010865:Pilot Projects; D011177:Postal Service; D017410:Practice Guidelines as Topic; D017010:Reminder Systems; D012189:Retrospective Studies; D013689:Telephone; D013921:Thrombocytopenia / Q000209:etiology; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014611:Vaccination
chemical_list: D000925:Anticoagulants
keywords: HSCT; adherence; compliance; stem cell; transplant; vaccination