Optimal Timing of Influenza Vaccination During 3-Week Cytotoxic Chemotherapy Cycles + comment

PracticeUpdate

  TAKE-HOME MESSAGE

• The authors of this randomized study evaluated the immunogenicity of an influenza vaccine at day 1 of chemotherapy with immunogenicity within the cytopenic period (day 11) during 3-week cycles of cytotoxic chemotherapy, finding that rates of seroprotection and seroconversion were similar between groups.
  
• The authors concluded that influenza vaccine can be effectively administered to patients undergoing cytotoxic chemotherapy, even during the cytopenic period.
  
  
  

  Abstract

  METHODS

  Adult patients with solid cancer undergoing scheduled 3-week cytotoxic chemotherapy were randomly assigned to receive the 2014-2015 seasonal influenza vaccine on day 1 or 11 during the chemotherapy cycle. Patients were stratified by their age (<60 and ≥60 years) and previous influenza vaccination status. Antibody responses to influenza vaccine strains H1N1, H3N2, and B were measured before and 21 to 28 days after vaccination with a hemagglutination inhibition antibody assay.
  

  RESULTS

  Ninety-seven patients were randomized into a day 1 group (n = 43) or a day 11 group (n = 54). Eighty-three patients were included in the final analysis. The mean age was 54 (± 11) years. Cancer types included breast (61%) and lung cancer (30%). Baseline characteristics were not significantly different between the groups. Seroprotection rates after vaccination were also not significantly different for the day 1 and 11 groups (strain H1N1, 67% vs 75% [P = .403]; strain H3N2, 77% vs 80% [P = .772]; strain B, 21% vs 27% [P = .472]). Seroconversion rates and postvaccination geometric mean titers were also similar for the groups. Vaccine-related adverse events were more common in the day 11 group (13% vs. 32%; P = .040).