4.5 Review

Lessons learnt from influenza vaccination in immunocompromised children undergoing treatment for cancer

Journal

LANCET CHILD & ADOLESCENT HEALTH
Volume 7, Issue 3, Pages 199-213

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/S2352-4642(22)00315-7

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Influenza infection is a major contributor to global morbidity and mortality, particularly for children with cancer who have weakened immune systems. Despite the availability of effective vaccines, there is still hesitancy among patients and oncologists regarding the optimal timing and method of vaccination. This review discusses the evidence and strategies to optimize influenza vaccination in children with cancer.
Influenza infection contributes substantially to global morbidity and mortality, with children undergoing treatment for cancer among the most vulnerable due to immunosuppression associated with disease and treatment. However, influenza remains one of the most common vaccine-preventable diseases. Despite international guidelines recommending inactivated influenza vaccination on the basis of data supporting efficacy and an excellent safety profile in this population, uptake has often been suboptimal due to persisting hesitancy among both patients and oncologists regarding the ability of the vaccine to mount a sufficient immune response, the optimal vaccine schedule and timing, and the best method to assess response in immunocompromised populations. In this Review, we discuss the evidence regarding influenza vaccination in children with cancer, factors that influence response, and highlight strategies to optimise vaccination. Host immune factors play a substantial role, thus principles learnt from influenza vaccination can be broadly applied for the use of inactivated vaccines in children with cancer.

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