Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Sep 1;8(1):e2016044.
doi: 10.4084/MJHID.2016.044. eCollection 2016.

Influenza and Pneumococcal Vaccination in Hematological Malignancies: a Systematic Review of Efficacy, Effectiveness, and Safety

Giuseppe La Torre  1 , Alice Mannocci  1 , Vittoria Colamesta  1 , Valeria D'Egidio  1 , Cristina Sestili  1 , Antonietta Spadea  2
Affiliations
Review

Influenza and Pneumococcal Vaccination in Hematological Malignancies: a Systematic Review of Efficacy, Effectiveness, and Safety

Giuseppe La Torre et al. Mediterr J Hematol Infect Dis. .

Abstract

Background: The risk of getting influenza and pneumococcal disease is higher in cancer patients, and serum antibody levels tend to be lower in patients with hematological malignancy.

Objective: To assess flu and pneumococcal vaccinations efficacy, effectiveness, and safety in onco-hematological patients.

Methods: Two systematic reviews and possible meta-analysis were conducted to summarize the results of all primary study in the scientific literature about the flu and pneumococcal vaccine in onco-hematological patients. Literature searches were performed using Pub-Med and Scopus databases. StatsDirect 2.8.0 was used for the analysis.

Results: 22 and 26 studies were collected respectively for flu and pneumococcal vaccinations. Protection rate of booster dose was 30% (95% CI=6-62%) for H1N1. Pooled prevalence protection rate of H3N2 and B was available for meta-analysis only for first dose, 42.6% (95% CI=23.2 - 63.3 %) and 39.6 % (95% CI=26%-54.1%) for H3N2 and B, respectively. Response rate of booster dose resulted 35% (95% CI=19.7-51.2%) for H1N1, 23% (95% CI=16.6-31.5%) for H3N2, 29% (95% CI=21.3-37%) for B.

Conclusion: Despite the low rate of response, flu, and pneumococcal vaccines are worthwhile for patients with hematological malignancies. Patients undergoing chemotherapy in particular rituximab, splenectomy, transplant recipient had lower and impaired response. No serious adverse events were reported for both vaccines.

PubMed Disclaimer

Figures

Figure 1
Figure 1
PRISMA Diagram for flu vaccination research strategy. *The papers were removed because they do not consider in the title or the abstract the flu vaccination and/or patients with a hematological tumor. **The papers were removed because they do not respect the inclusion criteria.
Figure 2a
Figure 2a
Forrest plots of Protection Rate stratify by a serotype of vaccine (Adults).
Figure 2b
Figure 2b
Forrest plots of Response Rate stratify by serotype of vaccine (Adults).
Figure 3
Figure 3
Forrest plots of Response Rate stratify by serotype of vaccine (children) independently from the dose (first or booster). Response rate H1N1 children
Figure 4
Figure 4
Flow-chart of pneumococcal research strategy.
See this image and copyright information in PMC

Comment in

References

    1. Yousuf HM, Englund J, Couch R, Rolston K, Luna M, Goodrich J, Lewis V, Mirza NQ, Andreeff M, Koller C, Elting L, Bodey GP, Whimbey E. Influenza among hospitalized adults with leukemia. Clin Infect Dis. 1997;24:1095–1099. doi: 10.1086/513648. - DOI - PubMed
    1. Centers for Disease Control and Prevention and Control of Influenza. Recommendations of the Advisory Committee on Immunization Practices ACIP. MMWR. 2009;58:1–52. www.cdc.gov/mmwr/preview. - PubMed
    1. Mackay HJ, McGee J, Villa D, Gubbay JB, Tinker LM, Shi L, Kuruvilla J, Wang L, MacAlpine K, Oza AM. Evaluation of pandemic H1N1 (2009) influenza vaccine in adults with solid tumor and hematological malignancies on active systemic treatment. J Clin Virol. 50:212–216. 201. - PubMed
    1. WHO. Relevé épidémiologique hebdomadaire. Pneumococcal vaccines WHO position paper – 2012. Wkly Epidemiol Rec. 2012;87:129–144. - PubMed
    1. Hamborsky J, Kroger, editors. E-Book: The Pink Book. Public Health Foundation; 2015. A Epidemiology and prevention of vaccine-preventable diseases.