Effect of medical staff training on vaccination coverage in outpatients with cancer: An interventional multicenter before-and-after study

Pierre Rivière; Nicolas Penel; Karine Faure; Guillaume Marie; Abeer Najem; Marie-Karelle Rivière; Sophie Panaget

doi:10.1016/j.jvacx.2023.100261

Effect of medical staff training on vaccination coverage in outpatients with cancer: An interventional multicenter before-and-after study

Vaccine X. 2023 Jan 8:13:100261. doi: 10.1016/j.jvacx.2023.100261. eCollection 2023 Apr.

Authors

Pierre Rivière¹, Nicolas Penel², Karine Faure³, Guillaume Marie¹, Abeer Najem¹, Marie-Karelle Rivière⁴, Sophie Panaget³

Affiliations

¹ Medical Oncology Department, Boulogne-sur-Mer Hospital, Boulogne-sur-Mer, France.
² Lille University (Medical School) and Medical Oncology Department, Centre Oscar Lambret, France.
³ Infectious Diseases Department, Lille University Hospital, Lille, France.
⁴ Saryga, Paris, France.

Abstract

Purpose: Despite widely disseminated guidelines, pneumococcal and influenza vaccination coverage (VC) remains insufficient in patients with cancer receiving cancer treatment. We performed an interventional study to evaluate VC in patients with cancer treated at the medical oncology departments of three North-of-France hospitals and to assess the effect of medical staff training on VC in these patients.

Methods: A standardized questionnaire assessed VC in adult patients with cancer receiving anticancer treatment at three day hospitals during December 2-7, 2019. Subsequently (January 2020), we organized educational training sessions for medical staff from each hospital to discuss the current vaccination guidelines. To assess the impact of training on pneumococcal and influenza VC, we re-administered the same questionnaire in March 2020. Because there are no specific guidelines on Diphtheria-Tetanus-Pertussis (DTP) vaccination and no improvement was expected, DTP VC acted as an internal control.

Results: In total, 272 patients from all three hospitals were enrolled in the "before study"; 156 patients from only two hospitals were enrolled in the "after study" as medical training and data collection at the third were impossible because of administrative reasons and COVID-19 pandemic. The predictors were age for DTP VC; treatment center for pneumococcal VC; and age, sex, and tumor histology (adenocarcinoma vs. others) for influenza VC. Neither influenza VC (42.6% vs. 55.1%, p = 0.08), nor pneumococcal VC were significantly improved post-intervention (11.8% vs. 15.4%, p = 1). There seems to be a small effect in the most fragile for influenza VC.

Conclusion: As expected, VC was very low in patients with cancer, consistent with the literature. There was no impact of the intervention for pneumococcal and influenza VC.

Keywords: Cancer; Chemotherapy; DTP, Diphtheria-Tetanus-Pertussis; Influenza; Medical training; PS, performance status; Streptococcus pneumoniae; VC, vaccine coverage; Vaccination coverage; WHO, World Health Organization.