Letters

We have read with interest the paper recently published in the Journal of Supportive Oncology about the lack of compliance with national vaccination guidelines in patients receiving radiation therapy.¹ Cancer patients, in particular those receiving chemotherapy and/or radiotherapy, are at an increased risk of contracting influenza and may have higher complication and mortality rates than the general immunocompetent population.^{[2] and [3]}

Patient safety goals recently issued by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and current Centers for Disease Control and Prevention (CDC) guidelines recommend vaccinations for all cancer patients over the ages of 65 (for pneumococcus) and 50 (annually, for influenza).^{[4] and [5]} Moreover, in a recent review, Pollyea et al.² reported that vaccination against seasonal influenza is indicated in immunocompromised patients, including those receiving anticancer chemotherapy, irrespective of their age.

However, there is some uncertainty among oncologists about the safety and efficacy of this procedure. Evidence indicates that fewer than 50% of patients treated with chemotherapy actually receive a vaccination.⁶ As published by Yee et al.,¹ 30% of patients treated with radiotherapy reported never receiving the influenza vaccine and only 7% of patients reported being asked or informed about the vaccination by their oncologists.

This uncertainty is probably due to several limitations in the available studies on this subject.² Considering these limitations, we carried out an observational monocentric study to evaluate influenza vaccine efficacy and safety in patients undergoing chemotherapy.