Influenza (flu) virus infection has a significant morbidity and mortality in excess of 5-10% especially in patients with medical co-morbidities who are also immune-suppressed. Influenza vaccination decreases all-cause mortality by about 30-50%. Patients undergoing chemotherapy along with the general public are vaccinated annually; there has been no study to assess the efficacy of influenza vaccination in these groups (patients on chemotherapy- POCT).
This is a prospective single arm, phase II open label study. 53 POCT with non-haematological cancers were recruited between 2011 and 2012 influenza seasons. POCT vaccinated in the current influenza season were excluded. Participants had one dose of 2011/2012 trivalent FluVax containing strains A/California/7/2009(H1N1); A/Perth/16/2009 (H3N2); B/Brisbane/60/2008 at least 3 days before chemotherapy. Primary endpoint was early seroconversion (SC) rate at 3weeks; other end-points were late SC rate at 6weeks; sustained SC and sero-protection (SP) at 24 weeks. Haem-agglutination inhibition (HAI) titres in serum were measured at baseline, 3, 6 and 24 weeks. Endpoint defined as SP (HAI ≥ 40); SC (≥4-fold increase titre).
53 patients; mean (sd) age 58.3(10.5) years; n(%) of Females 31(58.5). The results are displayed in the table below.
|Proportion N (%)|
|A/California/7/2009 (H1N1)||0||14 (35%)||14 (31.8%)||3 (7.5%)|
|A/Perth/16/2009(H3N2)||0||12 (30%)||12 (27.3%)||7 (17.5%)|
|B/Brisbane/60/2008||0||9 (22.5%)||8 (18.2%)||3 (7.5%)|
|A/California/7/2009 (H1N1)||23 (47.9%)||30 (75%)||33(75%)||16 (40%)|
|A/Perth/16/2009(H3N2)||19 (39.58%)||26 (65%)||26 (59.1%)||21 (52.5%)|
|B/Brisbane/60/2008||17 (42.5%)||17 (42.5%)||14 (31.8%)||8 (20%)|
POCT might have sub-optimal response to the FluVax. Our findings should be confirmed in a larger patient population and warrants further research into a more effective strategy in this patient group.
Clinical trial identification
Legal entity responsible for the study
Southern Adelaide Health Network Inc
All authors have declared no conflicts of interest.