Multiple Myeloma Vaccination Patterns in a Large Health System: A Pilot Study

Area of Science:

• Oncology
• Immunology
• Public Health

Background:

• Infections are a leading cause of mortality in multiple myeloma (MM).
• Increasing survival in MM necessitates strategies to prevent vaccine-preventable diseases.
• Immunomodulatory drugs used in MM treatment can impair immune responses to vaccines.

Purpose of the Study:

• To evaluate vaccination practice patterns for influenza and pneumonia in patients with multiple myeloma.
• To analyze the association between vaccination status and hospitalization rates and overall survival in MM patients.

Main Methods:

• Retrospective review of electronic medical records for 411 MM patients from May 2012 to May 2014.
• Data collected included demographics, influenza vaccination (FV) and pneumonia vaccination (PV) history, hospitalizations, costs, and survival.
• FV categorized as optimal, suboptimal, or none; PV defined as vaccination within 5 years.

Main Results:

• 58% of MM patients received pneumonia vaccination; influenza vaccination rates were 15% optimal, 52% suboptimal, and 33% none.
• Over 2 years, 444 hospitalizations occurred, costing over $23 million.
• No statistically significant difference in all-cause hospitalization or overall survival was observed based on FV or PV status.

Conclusions:

• Multiple myeloma patients exhibit low rates of influenza and pneumonia vaccination despite recommendations.
• Vaccination status (FV and PV) did not significantly impact hospitalization or survival in this pilot study.
• Prospective studies are required to determine the true immunological and clinical efficacy of vaccines in immunosuppressed MM patients.