A survey of immunization practices in children with cancer in India

Abstract

Context: Children with cancer, when on treatment and immunosuppressed, are at risk of infection from live vaccines and do not mount an adequate protective response to inactivated vaccines. Hence, immunizing them during and after treatment requires special considerations. Aim: We wanted to assess the current practice of clinicians caring for children with cancer in India regarding immunisation in these children during and after treatment. Methods and material: Clinicians from India attending the various pediatric cancer conferences in 2013 were invited to complete a questionnaire. Statistical analysis used: Data was analysed using software SPSS version 16 and GraphPad InStat version 3.05. Conventional statistics were used for analysis. Variation in practice was assessed by Fisher's exact test. Results: Responses form 37 institutes (response rate 74%) in 21 cities across India showed that there is variable practice of immunising children with cancer. There were areas of homogeneity (discontinuing all live vaccines during treatment and recommencing immunisation six months after end of treatment) and heterogeneity (continuation of inactivated vaccines and use of the hepatitis B vaccine during treatment). The variation was seen mainly among clinicians from public and private centres with no significant variation by annual caseload or duration of practice of the responding clinician. Variations were also observed in relation to sibling and parent vaccination. Conclusions: There is variation in the immunization practices in India in relation to children with cancer. Development and dissemination of immunisation guidelines specific to India would be useful in standardizing practice.

Keywords

• Child
• Cancer
• Immunisation
• India