Vaccination in pediatric cancer survivors: Vaccination rates, immune status, and knowledge regarding compliance.

BACKGROUND: Vaccination recommendations for childhood cancer survivors are ambiguous. Limited data exist on vaccination rates and patient/caregiver knowledge of vaccination postchemotherapy. PROCEDURE: A single-institution study of childhood cancer survivors treated from 1996 to 2018. Study included a retrospective chart review assessing patient's vaccination status, survey of patient's/caregiver's knowledge/beliefs regarding vaccination postchemotherapy, and assessment of immunoglobulin titers. RESULTS: A total of 120 patient charts were included. Vaccination records were available for 82% (98/120) of patients, 57% (56/98) were up to date with vaccinations before chemotherapy, and 83% (81/98) received vaccinations after chemotherapy. Children who resumed vaccination postchemotherapy were younger at cancer diagnosis compared to those who did not resume vaccination (2 vs 4 years, P < .02). Median time since chemotherapy was higher in vaccinated versus unvaccinated patients (107 vs 60 months, P < .02). Immunoglobulin titers were assessed in 27 patients, and 74% (20/27) were not immune to one or more infections tested. Lack of immunity to pneumococcal strains was the most common. There was no difference in median age at diagnosis or time since chemotherapy completion in immune versus nonimmune patients. In 33 surveyed patients/caregivers, 33% (11/33) were not advised about resuming vaccinations postchemotherapy. Over one-third (12/33) of respondents were concerned about vaccination safety after chemotherapy, although 88% (29/33) agreed they would vaccinate if recommended by their pediatrician/pediatric oncologist. CONCLUSIONS: Most childhood cancer survivors resume vaccinations postchemotherapy. Considerable variability exists in vaccination timing after chemotherapy. Pediatric oncologists play a central role in educating patients/pediatricians about vaccination recommendations postchemotherapy.

Long-term telemental health prevention interventions for youth: A rapid review.

INTRODUCTION: This rapid review identifies and summarizes the effectiveness of preventative telemental health interventions. It investigates studies conducted between 2010 and 2016 that improve mood and anxiety with long-term follow-up. METHODS: A literature search of three major databases was performed by four reviewers. After citation tracing, 3604 studies were discovered, and twenty of these met the inclusion criteria. Data from the papers were abstracted, assessed for quality, and effect sizes were calculated. RESULTS: Salient information was discussed using the Behavioural Vaccine Model of mental illness prevention. This included key concepts such as efficacy, duration of benefits, sociocultural relevance, professional guidance, peer-to-peer support, adherence, delivery and safety. CONCLUSION: This review suggests there are clear prolonged benefits to using technology in youth mental illness prevention. Although this is a rapidly growing area of investigation in countries around the globe, there is still a dearth of research with long-term follow-up. Future studies should aim to boost engagement by increasing motivational guidance in order to recruit at-risk youth of all demographics into these promising intervention programs.