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Influenza immunization in immunosuppressed children.
The Journal of Pediatrics
|January 1, 1978
Summary
Optimal influenza immunization for children with cancer requires careful timing. Immunizing one month after chemotherapy, with white blood cell counts over 1,000, significantly improves vaccine response.
Area of Science:
- Pediatric Oncology
- Immunology
- Vaccinology
Background:
- Individuals with malignancy and immunodeficient states have altered immune responses to standard vaccinations.
- Understanding optimal immunization strategies is crucial for this vulnerable population.
Purpose of the Study:
- To evaluate the immunogenicity of influenza vaccine in children with malignancy.
- To identify factors influencing vaccine response, particularly the impact of chemotherapy.
Main Methods:
- Children aged 3-17 with malignancies received a bivalent influenza vaccine (A/New Jersey/76 and A/Victoria/75).
- Two-dose immunization schedule was administered.
- Seroconversion rates were assessed using hemagglutination inhibition titers.
Main Results:
- Seroconversion rates for A/NJ/76 were significantly lower in children on chemotherapy (37%) compared to those not on chemotherapy (92%, P < 0.001).
- Immune response to A/Vic/75 also correlated with recent chemotherapy history.
- Peripheral white blood cell count showed no correlation with immune response, except at counts ≤1,000.
Conclusions:
- Optimal timing for influenza immunization in children with malignancies is one month post-chemotherapy.
- Maintaining peripheral white blood cell counts >1,000 is recommended for effective immunization.
- These findings inform vaccination protocols for immunocompromised pediatric cancer patients.