Deficits in Long-Term Vaccine Immunity Among Childhood Cancer Survivors Despite Revaccination Programs
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Cohort
2.2. Sample and Data Collection
2.3. Serological Assays
2.4. Statistical Analysis
3. Results
3.1. Characteristics of the Study Population
3.2. Seroprevalence of Tetanus IgG and Rubella IgG
3.3. Status of Revaccination and Protective Antibodies Depending on Degree of Immunosuppression
3.4. Association of Antibody Prevalence with Different Background Variables
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
CCSs | childhood cancer survivors |
Abs | antibodies |
NIP | national immunization program |
DTP | diphtheria–tetanus–pertussis |
MMR | measles–mumps–rubella |
IgG | immunoglobulin G |
CNS | central nervous system |
ALL | acute lymphoblastic leukemia |
Appendix A
References
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Solid Tumors | CNS Tumors | Leukemia/Lymphoma * | ||
---|---|---|---|---|
n = 51 | n = 23 | n = 106 | ||
Age at diagnosis (years) | 8 (0–17 ) | 5 (0–14) | 7.5 (0–17) | p = 0.056 |
median (range) | ||||
Preschool (0–5 yrs) n (%) | 22 (43) | 12 (61) | 83 (46) | |
School (6–12 yrs) n (%) | 17 (33) | 8 (35) | 54 (30) | |
Teenagers (13–18 yrs) n (%) | 12 (24) | 1 (4) | 43 (24) | |
Follow-up time (years) | 9 (1–17.5) | 13 (2–18) | 10.5 (1–18.5) | p = 0.078 |
median (range) | ||||
Estimated treatment intensity n (%) | p < 0.001 | |||
Mild | 1 (2) | 1 (4) | 5 (5) | |
Moderate | 16 (32) | 11 (48) | 0 (0) | |
Intensive | 34 (66) | 11 (48) | 101 (95) | |
Relapse n (%) | 6 (12) | 3 (13) | 8 (7) | p = 0.496 |
Revaccination n (%) | ||||
DTP | 25/51 (49%) | 9/23 (39%) | 72/106 (68%) | p = 0.009 |
MMR | 19/51 (37%) | 5/23 (22%) | 56/106 (53%) | p = 0.011 |
Intensity of Treatment | Mild | Moderate | Intense |
---|---|---|---|
n = 7 | n = 27 | n = 146 | |
DTP n (%) | |||
Revaccination | n = 1 | n = 9 | n = 98 * |
Tetanus IgG > cut-off | 1 (100.0) | 9 (100.0) | 81 (82.6) |
Tetanus IgG < cut-off | 0 (0.0) | 0 (0.0) | 13 (13.2) |
No revaccination * | n = 6 | n = 18 * | n = 48 |
Tetanus IgG > cut-off | 5 (83.3) | 16 (88.8) | 24 (50.0) |
Tetanus IgG < cut-off | 1 (17.7) | 1 (5.6) | 24 (50.0) |
MMR n (%) | |||
Revaccination | n = 2 # | n = 5 # | n = 73 # |
Rubella IgG > cut-off | 1 (50.0) | 4 (80.0) | 57 (78.1) |
Rubella IgG < cut-off | 0 (0.0) | 0 (0.0) | 14 (19.2) |
No revaccination | n = 5 | n = 22 # | n = 73 # |
Rubella IgG > cut-off | 5 (100.0) | 16 (72.7) | 53 (72.6) |
Rubella IgG < cut-off | 0 (0.0) | 5 (22.7) | 17 (23.2) |
Tetanus | Rubella | |||||
---|---|---|---|---|---|---|
IgG < Cut-off (n = 39) | IgG > Cut-off (n = 136) | p-Value | IgG < Cut-off (n = 36) | IgG > Cut-off (n = 136) | p-Value | |
Age at diagnosis, n | 0.160 | 0.036 | ||||
0–5 years | 22 | 60 | 21 | 57 | ||
6–12 years | 7 | 46 | 5 | 48 | ||
13–18 years | 10 | 30 | 10 | 31 | ||
Diagnosis group, n | 0.175 | 0.587 | ||||
Solid tumors | 7 | 42 | 8 | 41 | ||
CNS tumors | 4 | 19 | 4 | 17 | ||
Leukemia/lymphoma | 28 | 75 | 24 | 78 | ||
Treatment intensity, n | 0.023 | 0.667 | ||||
Mild | 1 | 6 | 0 | 6 | ||
Moderate | 1 | 25 | 5 | 20 | ||
Intense | 37 | 105 | 31 | 110 | ||
DTP revaccination *, n | <0.001 | |||||
Yes | 13 | 91 | n/A | n/A | ||
No | 26 | 45 | n/A | n/A | ||
MMR revaccination #, n | 0.572 | |||||
Yes | n/A | n/A | 14 | 62 | ||
No | n/A | n/A | 22 | 74 |
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Zadruzny, A.; Tiselius, E.; Lepp, T.; Aktas, T.; Tecleab, T.; Hellman, S.; Jahnmatz, M.; Nilsson, A. Deficits in Long-Term Vaccine Immunity Among Childhood Cancer Survivors Despite Revaccination Programs. Vaccines 2025, 13, 617. https://doi.org/10.3390/vaccines13060617
Zadruzny A, Tiselius E, Lepp T, Aktas T, Tecleab T, Hellman S, Jahnmatz M, Nilsson A. Deficits in Long-Term Vaccine Immunity Among Childhood Cancer Survivors Despite Revaccination Programs. Vaccines. 2025; 13(6):617. https://doi.org/10.3390/vaccines13060617
Chicago/Turabian StyleZadruzny, Alexander, Eva Tiselius, Tiia Lepp, Teodora Aktas, Teghesti Tecleab, Samuel Hellman, Maja Jahnmatz, and Anna Nilsson. 2025. "Deficits in Long-Term Vaccine Immunity Among Childhood Cancer Survivors Despite Revaccination Programs" Vaccines 13, no. 6: 617. https://doi.org/10.3390/vaccines13060617
APA StyleZadruzny, A., Tiselius, E., Lepp, T., Aktas, T., Tecleab, T., Hellman, S., Jahnmatz, M., & Nilsson, A. (2025). Deficits in Long-Term Vaccine Immunity Among Childhood Cancer Survivors Despite Revaccination Programs. Vaccines, 13(6), 617. https://doi.org/10.3390/vaccines13060617