572. Vaccination Guidelines after Stem Cell Transplantation: Practitionersí Knowledge and Attitudes and the Gap between Guidelines and Clinical Practice
Session: Oral Abstract Session: Immunization of Children and Adults with Immune Deficiencies
Thursday, October 3, 2013: 2:30 PM
Room: The Moscone Center: 250-262
Background: Stem cell transplant (SCT) recipients are more susceptible to infections from vaccine preventable diseases than regular population. As a result, it is essential to provide protection against these organisms to decrease the number of persons vulnerable to infections that can spread rapidly. Despite the development of SCT immunization guidelines by an international group of experts in 2009, practices regarding the optimal selection and administration of vaccines vary widely. In 2009, our institution devised a standard operating procedure for vaccinations post-SCT based on guidelines.

Methods: An anonymous online survey was distributed to faculty and staff of the SCT service. Questions were aimed at determining awareness of guidelines and attitudes toward vaccination after SCT. In parallel, a retrospective evaluation was undertaken using our institution’s pharmacy database to determine vaccines administered post-SCT after 2009.

Results: Thirty-two physicians and midlevel practitioners received the survey. The response rate was 72% (23/32). According to the survey, 96% of the respondents were familiar with the institution’s post-SCT vaccination protocol. The most common reasons for delayed vaccination were use of steroids (70%) and graft-versus-host disease (GVHD) (87%). Seventy percent of respondents reported prescribing influenza vaccine, and 30% reported administering live vaccines to eligible patients. Our review of the data collected from the pharmacy database showed that an average of 25% of patients received the first series of vaccinations by 6 months post-SCT, and 60% fulfilled vaccination protocols by 1 year after SCT. Moreover, 40% of patients received influenza vaccine, and 2% of eligible patients were vaccinated against live viruses.

Conclusion: We described a gap between clinician knowledge, attitudes and clinical practice regarding vaccination post-SCT. Respondents to this survey reported being aware of current guidelines, however, according to our pharmacy database review, the majority of them did not adhere to guidelines-driven practices. Additionally, despite recommendations for vaccination in patients with GVHD or on steroids, an overwhelming majority of our physicians chose to hold vaccination for these patients, reflecting on low vaccinations rates.

Ella Ariza-Heredia, MD1, Alison Gulbis, PharmD2, Partow Kebriaie, MD2, Karen Stolar, RN, MS2, Victor Mulanovich, MD3, Kelly Mcconn, PA2, Richard Champlin, MD2 and Roy Chemaly, MD, MPH1, (1)Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, (2)MD Anderson Cancer Center, Houston, TX, (3)Infectious Diseases, Infection Control & Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX

Disclosures:

E. Ariza-Heredia, None

A. Gulbis, None

P. Kebriaie, None

K. Stolar, None

V. Mulanovich, None

K. Mcconn, None

R. Champlin, None

R. Chemaly, None

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