Immunization Practices of Pediatric Oncology Providers Towards Children with Acute Lymphoblastic Leukemia that have Completed Chemotherapy
Methods: A cross-sectional study was performed using survey methodology. An anonymous 33-item questionnaire was electronically distributed on three separate occasions over a 4 week period via REDCap to members of the American Society of Pediatric Hematology and Oncology (ASPHO). The questionnaire was adapted with permission from a previously validated survey instrument.
Results: The questionnaire was completed by 350 of 1602 ASPHO members (21.9% response rate). Respondents were primarily clinicians (75%) at university-affiliated (75%) pediatric institutions (58%). A majority of respondents (95%) believe that immunizations are extremely effective in the general population; only 31% believe immunizations are extremely effective in children after ALL chemotherapy. Most respondents agree it is safe to give vaccines >12 months (99%) and 6 to 12 months (71%) after completion of chemotherapy. Only 13% agree that vaccines are safe in the first 6 months post chemotherapy. 42% of care providers always or often recommend re-immunization after chemotherapy for ALL while 40% rarely or never recommend re-immunization. When providers do re-immunize, the majority do so after 6 months (73%). Common reasons for not re-immunizing include a perceived lack of need, lack of published evidence, and lack of guidelines.
Conclusion: These results reveal significant variation in the approach to reimmunization for children that have completed ALL chemotherapy. Lack of evidence and guidelines to direct clinicians as to who and when to reimmunize were identified as barriers. Future efforts should focus on establishing universal guidelines to standardize care and identify research gaps for further investigation.
A. Esbenshade, None
R. Xiao, None
B. T. Fisher, None
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