Table 1.

Recommendations and statements on the use of vaccination for seasonal influenza in patients with cancer

Influenza vaccination in patients with cancer is safe, minimally invasive, and inexpensive.

It should be widely utilized in patients with cancer both untreated and receiving active therapy, including biologic agents for solid tumors. The ideal time to administer the vaccination during a treatment cycle is unclear.

Vaccination of household contacts and health care personnel is highly recommended as it bears significant implications in increasing the level of herd immunity in the microenvironment with consequent reduction of influenza virus circulation and likelihood of infection.

Strict preventive measures should be adopted in oncology wards in the presence of hospitalized patients who develop influenza-like illness.

Trivalent inactivated vaccine should be given. Data suggest an increased seroprotection rate by means of vaccines with adjuvants, an higher doses of antigen, or a second dose of vaccine. A quadrivalent vaccine has been recently approved by the United States and European health authorities.

Cancer patients treated with rituximab-containing regimens have persisting perturbations of B-cell compartments and an impaired immune response to influenza vaccine, but also to other common vaccines. Thus, special efforts are needed to improve preventive/therapeutic strategies for these refractory patients, including prophylactic antivirals.

Prospective randomized, controlled trials to better define the serological response and the clinical benefits of influenza vaccination are needed in this patient population.