Influenza Vaccination for Cancer Patients: An Algerian Single Center Experience

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Abstract

Background: Viral infections are very severe infections and can be responsible for death, as is the case with influenza infection; which during a short period of spread can cause significant deaths in the general population, and in immunocompromised patients in particular; as is the case with cancer patients; weakened by the disease and viral infection too. Patients with cancer are at high risk of severe infections complications. Among people with immunosuppression due to chemotherapy, corticosteroid treatment, or immunotherapy, high rates of influenza infection and related complications are frequently observed. In Algeria, the influenza vaccine is recommended for people aged 65 and over, as well as for those with chronic medical conditions who are at high risk of complications. It is offered by the government free of charge to elderly and other risk groups and distributed through general hospitals and pharmacists Material and methods: The medical oncology department of the Establishment DIDOUCHE Mourad, Constantine, launched a vaccination campaign for eligible patients, during the vaccination campaign initiated by the Algerian Ministry of Health during seasonal infection from October to December, each year. During two (02) months of medical oncology consultations (November 2024 to December 2024), 2047 patients were consulted and 264 patients were concerned by the vaccination. The findings emphasize the crucial role of healthcare professionals in advocating for influenza vaccination among cancer patients and the need for collaboration with health authorities to improve vaccination coverage Results: For a total of 2047 patients consulted (whose 43 (2,10 %) were already vaccinated), 892 (43.57%) patients refused the idea of vaccination. 784 (38.29%) patients did not want to comment yet at the time of the consultation and preferred to continue their treatments, 53 (2.58%) were postponed for bone marrow aplasia. 11 (0.53%) patients had contraindications to vaccination including 3 (27.27%) egg allergy, 2 (18.18%) tuberculosis, 2 (18.18%) febril neutropenia ,2 (18.18%%) recent ischemic stroke (less than 20 days), 1 (9.09%) on treatment with Rituximab and 1 (9,09%) patient had a recent Guillan Barre Syndrom. (less than 6 weeks). 264 cancer patients ((12.89%) were included in the study of adherence to a vaccination campaign launched in medical oncology department of the hospital establishment DIDOUCHE Mourad, Constantine 189 (71.60%) patients were women and 75 (28.40%) patients were men. Different tumor localizations were noted. As a result, the influenza vaccination campaign coverage in our study was 13,17 % for all ages of cancer patients included and 48,86 % for those ≥ 65 years. Discussion: The influenza vaccination coverage was low among cancer patients. Influenza non-vaccination in the previous season was the strongest predictor of not receiving influenza vaccination in the current season. The main reasons for the low level of vaccination coverage rate that emerged in our study were having no-informations for indication to cancer patients (41,28%), fear of side effects (31,43%) getting medical treatment for cancer (chemotherapy, targeted therapy or immunotherapy ) (9,46%), lack of efficacy (9,09%), and no-need (8,71%). Nevertheless, after having informations and advice by medical oncologists, all patients stated that they will get vaccine next year. Conclusion: Vaccination against influenza in patients with cancer is a serious issue that presents many challenges, mainly in association with the immunocompromised state of these patients. Owing to disease and/or treatment-associated immunosuppression, patients with cancer are vulnerable to infectious diseases and are at high risk of developing infection- related complications, including those associated with influenza. Vaccination against common preventable diseases, including seasonal influenza, is therefore highly recommended in these patients.

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