(44) Seroprotection to Vaccine Preventable Diseases in Survivors of Pediatric Cancers Following Standard-of-Care Therapy- A Scoping Review

Title: Seroprotection to Vaccine Preventable Diseases in Survivors of Pediatric Cancers Following Standard-of-Care Therapy- A Scoping Review

Abstract : Due to improved treatment regimens, survivorship following childhood cancer has increased in recent years. As such, today about 1 in 500 Americans is a survivor of childhood cancer. Studies suggest survivors of pediatric cancers may be at increased risk for vaccine preventable diseases (VPD) following cancer treatment. Relative to those without a previous cancer diagnosis, pediatric survivors were found to have a 13.1x higher risk for contracting a VPD, suggesting persistent humoral immune dysfunction in survivorship. Increased incidence of VPD outbreaks in conjunction with a growing number of vulnerable survivors could place this population at increased risk for common communicable diseases.
Limited synthesis of literature on this subject restricts the ability of clinicians to create appropriate guidelines. In an effort to contribute to this lacking body of evidence, a scoping review of the literature was performed to identify articles reporting rate of protection to common VPDs in survivors of pediatric malignancies, as well as additional factors that may contribute to under-protection.
A systematic examination of published literature concerning rate of immunity to vaccine preventable diseases following treatment for childhood cancer was carried out on three research databases: Pubmed, Web of Science and Embase. Seventeen articles were selected with respect to inclusion and exclusion criteria. Quality was evaluated against specific methodological standards. Rate of immunity at end of treatment (EOT) and following re-vaccination was extracted. Additional variables such as age at diagnosis, disease type and treatment intensity were examined for effect on immunity.
Rate of immunity to inactivated vs live attenuated vaccines did not differ at EOT. A majority of participants recovered immunity after vaccination with inactivated vaccines, while a smaller percentage of participants recovered immunity when vaccinated with live attenuated vaccines. There is no clear evidence that age at diagnosis, disease type, or treatment intensity are significant to under-protection.