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Oxford Journals
Medicine
Journal of Infectious Diseases
Advance Access
10.1093/infdis/jir563
Make New Friends, But Keep the Old: Influenza Vaccines in Children With Cancer
Natasha B. Halasa
+ Author Affiliations
Department of Pediatric Infectious Diseases, Vanderbilt University, Nashville, Tennessee
Correspondence: Natasha Halasa, MD, MPH, Dept of Pediatric Infectious Diseases, Vanderbilt University, 1161 21st Ave South, MCN D7232, Nashville, TN 37232 (natasha.halasa@Vanderbilt.Edu).
Influenza is an important cause of morbidity and mortality worldwide. Children exhibit the highest rates of influenza virus infection, whereas older adults have the highest mortality rates [ 1, 2]. However, half of all influenza-related deaths occur in groups with other risk factors [ 1, 2]. These risk factors include immune compromise, particularly in patients with cancer, because of both immune compromise from their disease and myelosuppressive chemotherapy. Within a given community, an influenza epidemic may last 5?6 weeks and may be associated with attack rates as high as 10%?20% in the general population; however, attack rates are higher among individuals with cancer [ 3? 5].
In this issue of the Journal, Carr et al [ 6] from St. Jude Children?s Hospital report an open-label, single-site trial that compares the safety and immunogenicity of live attenuated influenza vaccine (LAIV) with trivalent inactivated vaccine (TIV) in mildly to moderately immunocompromised children with cancer. The authors enrolled 55 subjects with a mean age of 10.4 years; 28 subjects received LAIV, and 27 received TIV. This work builds upon prior investigations of influenza vaccines in immunocompromised children.
In 1977, Feldman et al [ 7] characterized the clinical features of laboratory-confirmed influenza in 20 children and young adults with cancer. Symptoms of influenza infection were typical but lasted twice as long as in the general population [ 7]. In addition, 16 patients had chemotherapy withheld for 4 days?3.5 weeks. In 1989, Kempe et al [ 4] reported a higher frequency of influenza infection among children with cancer (23 [32%] of 73 children), compared with community control subjects (10 [14%] of 70; P = .02) in a prospective study of influenza among unimmunized, immunosuppressed children with cancer. A more recent study by Tasian et ?
Medicine
Journal of Infectious Diseases
Advance Access
10.1093/infdis/jir563
Make New Friends, But Keep the Old: Influenza Vaccines in Children With Cancer
Natasha B. Halasa
+ Author Affiliations
Department of Pediatric Infectious Diseases, Vanderbilt University, Nashville, Tennessee
Correspondence: Natasha Halasa, MD, MPH, Dept of Pediatric Infectious Diseases, Vanderbilt University, 1161 21st Ave South, MCN D7232, Nashville, TN 37232 (natasha.halasa@Vanderbilt.Edu).
Influenza is an important cause of morbidity and mortality worldwide. Children exhibit the highest rates of influenza virus infection, whereas older adults have the highest mortality rates [ 1, 2]. However, half of all influenza-related deaths occur in groups with other risk factors [ 1, 2]. These risk factors include immune compromise, particularly in patients with cancer, because of both immune compromise from their disease and myelosuppressive chemotherapy. Within a given community, an influenza epidemic may last 5?6 weeks and may be associated with attack rates as high as 10%?20% in the general population; however, attack rates are higher among individuals with cancer [ 3? 5].
In this issue of the Journal, Carr et al [ 6] from St. Jude Children?s Hospital report an open-label, single-site trial that compares the safety and immunogenicity of live attenuated influenza vaccine (LAIV) with trivalent inactivated vaccine (TIV) in mildly to moderately immunocompromised children with cancer. The authors enrolled 55 subjects with a mean age of 10.4 years; 28 subjects received LAIV, and 27 received TIV. This work builds upon prior investigations of influenza vaccines in immunocompromised children.
In 1977, Feldman et al [ 7] characterized the clinical features of laboratory-confirmed influenza in 20 children and young adults with cancer. Symptoms of influenza infection were typical but lasted twice as long as in the general population [ 7]. In addition, 16 patients had chemotherapy withheld for 4 days?3.5 weeks. In 1989, Kempe et al [ 4] reported a higher frequency of influenza infection among children with cancer (23 [32%] of 73 children), compared with community control subjects (10 [14%] of 70; P = .02) in a prospective study of influenza among unimmunized, immunosuppressed children with cancer. A more recent study by Tasian et ?
