Vaccination coverage in cancer outpatients: An interventional multicenter before/after study
2021
Background: Despite largely diffused guidelines, Pneumococcal and Influenza vaccination coverage (VC) remains insufficient in cancer patients receiving chemotherapy. We evaluated VC and carried out an interventional study to improve VC in cancer patients treated in 3 medical oncology departments in 3 hospitals of North-of- France. Methods: Using a standardized questionnaire, we assessed the VC in adult cancer patients receiving anticancer treatment in day hospital between 02 and 07 Dec. 2019. Then, in each hospital, we organized trainings with physicians to discuss the current vaccination guidelines (January 2020). Finally, to assess the impact of this intervention on Pneumococcal and Influenza VC, we have conducted a similar survey using the same questionnaire in March 2020. Since there were no specific guidelines on Diphtheria-Tetanus-Pertussis (DTP) VC and we did not expect an improvement, we have monitored DTP VC as internal control. Results: 272 patients have been enrolled in the 'before study' in the 3 hospitals, whereas 156 patients have been enrolled in the 'after study' in only 2 hospitals (the after-study was not feasible in 3rd hospital because of COVID-19 pandemic national containment). Predictors associated with DTP VC was age, with Pneumococcal VC was center and with Influenza VC were age, gender and tumor histology (adenocarcinoma vs others). Influenza VC was significantly improved after intervention (42.6 vs 55.1% with p = 0.016) especially in fragile patients, but Pneumococcal VC was not (11.8 vs 15.4% with p = 0.357). Conclusions: As expected, VC was very low in cancer patients, our figures are consistent with literature data. The impact of intervention (training of physicians) is limited without improvement of Pneumococcal VC. We presume that this increase in Influenza VC mainly reflects the overall result of national Influenza vaccination campaign.
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