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.
Procedures: 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.
Conclusion: 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.
(Copyright 2009 Wiley-Liss, Inc.)