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    Immunogenicity and clinical effectiveness of the trivalent inactivated influenza vaccine in immunocompromised children undergoing treatment for cancer

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    Author
    Kotecha, RS; Wadia, UD; Jacoby, P; Ryan, AL; Blyth, CC; Keil, AD; Gottardo, NG; Cole, CH; Barr, IG; Richmond, PC
    Date
    2016-02-01
    Source Title
    Cancer Medicine
    Publisher
    WILEY
    University of Melbourne Author/s
    Barr, Ian
    Affiliation
    Microbiology and Immunology
    Metadata
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    Document Type
    Journal Article
    Citations
    Kotecha, R. S., Wadia, U. D., Jacoby, P., Ryan, A. L., Blyth, C. C., Keil, A. D., Gottardo, N. G., Cole, C. H., Barr, I. G. & Richmond, P. C. (2016). Immunogenicity and clinical effectiveness of the trivalent inactivated influenza vaccine in immunocompromised children undergoing treatment for cancer. CANCER MEDICINE, 5 (2), pp.285-293. https://doi.org/10.1002/cam4.596.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256367
    DOI
    10.1002/cam4.596
    Abstract
    Influenza is associated with significant morbidity and mortality in children receiving therapy for cancer, yet recommendation for, and uptake of the seasonal vaccine remains poor. One hundred children undergoing treatment for cancer were vaccinated with the trivalent inactivated influenza vaccine according to national guidelines in 2010 and 2011. Influenza-specific hemagglutinin inhibition antibody titers were performed on blood samples taken prior to each vaccination and 4 weeks following the final vaccination. A nasopharyngeal aspirate for influenza was performed on all children who developed an influenza-like illness. Following vaccination, seroprotection and seroconversion rates were 55 and 43% for H3N2, 61 and 43% for H1N1, and 41 and 33% for B strain, respectively. Overall, there was a significant geometric mean fold increase to H3N2 (GMFI 4.56, 95% CI 3.19-6.52, P < 0.01) and H1N1 (GMFI 4.44, 95% CI 3.19-6.19, P < 0.01) strains. Seroconversion was significantly more likely in children with solid compared with hematological malignancies and in children <10 years of age who received a two-dose schedule compared to one. Influenza infection occurred in 2% of the vaccinated study population, compared with 6.8% in unvaccinated controls, providing an adjusted estimated vaccine effectiveness of 72% (95% CI -26-94%). There were no serious adverse events and a low reactogenicity rate of 3%. The trivalent inactivated influenza vaccine is safe, immunogenic, provides clinical protection and should be administered annually to immunosuppressed children receiving treatment for cancer. All children <10 years of age should receive a two-dose schedule.

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