Rivière Pierre, Penel Nicolas, Faure Karine, Marie Guillaume, Najem Abeer, Rivière Marie-Karelle, Panaget Sophie
Medical Oncology Department, Boulogne-sur-Mer Hospital, Boulogne-sur-Mer, France.
Lille University (Medical School) and Medical Oncology Department, Centre Oscar Lambret, France.
Vaccine X. 2023 Jan 8;13:100261. doi: 10.1016/j.jvacx.2023.100261. eCollection 2023 Apr.
Despite widely disseminated guidelines, pneumococcal and influenza vaccination coverage (VC) remains insufficient in patients with cancer receiving cancer treatment. We performed an interventional study to evaluate VC in patients with cancer treated at the medical oncology departments of three North-of-France hospitals and to assess the effect of medical staff training on VC in these patients.
A standardized questionnaire assessed VC in adult patients with cancer receiving anticancer treatment at three day hospitals during December 2-7, 2019. Subsequently (January 2020), we organized educational training sessions for medical staff from each hospital to discuss the current vaccination guidelines. To assess the impact of training on pneumococcal and influenza VC, we re-administered the same questionnaire in March 2020. Because there are no specific guidelines on Diphtheria-Tetanus-Pertussis (DTP) vaccination and no improvement was expected, DTP VC acted as an internal control.
In total, 272 patients from all three hospitals were enrolled in the "before study"; 156 patients from only two hospitals were enrolled in the "after study" as medical training and data collection at the third were impossible because of administrative reasons and COVID-19 pandemic. The predictors were age for DTP VC; treatment center for pneumococcal VC; and age, sex, and tumor histology (adenocarcinoma vs. others) for influenza VC. Neither influenza VC (42.6% vs. 55.1%, p = 0.08), nor pneumococcal VC were significantly improved post-intervention (11.8% vs. 15.4%, p = 1). There seems to be a small effect in the most fragile for influenza VC.
As expected, VC was very low in patients with cancer, consistent with the literature. There was no impact of the intervention for pneumococcal and influenza VC.
尽管有广泛传播的指南，但接受癌症治疗的癌症患者中肺炎球菌和流感疫苗接种覆盖率（VC）仍然不足。我们进行了一项干预性研究，以评估法国北部三家医院肿瘤内科接受治疗的癌症患者的疫苗接种覆盖率，并评估医务人员培训对这些患者疫苗接种覆盖率的影响。
采用标准化问卷评估2019年12月2日至7日在三家日间医院接受抗癌治疗的成年癌症患者的疫苗接种覆盖率。随后（2020年1月），我们为每家医院的医务人员组织了教育培训课程，以讨论当前的疫苗接种指南。为了评估培训对肺炎球菌和流感疫苗接种覆盖率的影响，我们于2020年3月重新发放了相同的问卷。由于没有关于白喉-破伤风-百日咳（DTP）疫苗接种的具体指南，且预计不会有改善，DTP疫苗接种覆盖率作为内部对照。
三家医院共有272例患者纳入“研究前”；由于行政原因和新冠疫情，只有两家医院的156例患者纳入“研究后”，第三家医院无法进行医学培训和数据收集。预测因素中，DTP疫苗接种覆盖率与年龄有关；肺炎球菌疫苗接种覆盖率与治疗中心有关；流感疫苗接种覆盖率与年龄、性别和肿瘤组织学（腺癌与其他）有关。干预后，流感疫苗接种覆盖率（42.6%对55.1%，p = 0.08）和肺炎球菌疫苗接种覆盖率均未显著提高（11.8%对15.4%，p = 1）。对于流感疫苗接种覆盖率，似乎对最脆弱的患者有轻微影响。
正如预期的那样，癌症患者的疫苗接种覆盖率非常低，与文献一致。干预对肺炎球菌和流感疫苗接种覆盖率没有影响。
