STOCKHOLM -- Vaccination coverage for very severe manifestations of influenza remains low in patients with cancer, even though they are at high risk.

Just 34% of 112 consecutive cancer patients receiving treatment at the Hopital Cochin, Paris, also received flu shots in 2008. Of these, 14%

The main reasons for absence of vaccination were lack of prompting by the treating physician (72%), fear of side effects (33%), and concerns about vaccine efficacy (10%), Dr. Pierre Loulergue reported in an award-winning poster at the European Society of Medical Oncology Congress.

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General practitioners administered the flu shots in 56% of vaccinated patients. "The GP could do 100% of vaccinations," Dr. Loulergue said in an interview. "But the oncologist must be more aware of the necessity to vaccinate."

Dr. Loulergue said if cancer patients have influenza, the consequences can be more severe and can delay chemotherapy. Guidelines in France and in the United States recommend vaccination against influenza in all immunocompromised patients. However, the leading reason cited by oncologists for not giving the flu shot was the lack of awareness of recommendations.

In a previous study, one-third of 214 radiotherapy patients (aged 50 years or older) at the University of Pennsylvania, Philadelphia, said they never had an annual flu shot. Only 7% said a cancer specialist discussed vaccinations with them, compared with 44% of general practitioners (FAMILY PRACTICE NEWS, Dec. 1, 2007, p. 18).

Studies have also suggested lower influenza vaccination immunogenicity in chemotherapy patients, Dr. Loulergue said. The investigators hope to address immunogenicity in a follow-up study.

In the current study, patients (aged 1687 years) had received chemotherapy for a median time of 7 months (range, 1-41 months). Indications included colorectal (21%), lung (16%), prostate (15%), sarcoma (8%), and urothelial (7%) cancer.

Vaccinated patients were significantly older than those not vaccinated (70 vs. 59 years) and were more likely to have received a vaccination voucher from the French national health insurance agency (71% vs. 36%). The researchers reported no conflicts of interest.

BY PATRICE WENDLING

Chicago Bureau