Supportive Care in Cancer

, Volume 25, Issue 12, pp 3815–3822 | Cite as

Vaccination against influenza at a European pediatric cancer center: immunization rates and attitudes among staff, patients, and their families

  • Aleksandra Pettke
  • Sophie Jocham
  • Andreas Wiener
  • Andreas Löcken
  • Judith Groenefeld
  • Martina Ahlmann
  • Andreas H. Groll
Original Article



Influenza is an important cause of infectious morbidity in pediatric cancer patients. We conducted a single-center survey to explore adherence and attitudes towards the recommended annual influenza vaccination.


Self-administered, standardized questionnaires were distributed to 143 staff members and 264 families. Items analyzed included demographic data, knowledge about influenza, history of prior influenza infections and vaccinations, routes of information and education, and attitudes towards the recommended influenza. Variables associated with vaccination were explored by univariate and multivariate analyses.


One hundred six staff members with patient contact and 139 primary caretakers completed the questionnaire. Fifty-nine percent of staff members and 60% of the caretakers provided correct answers to all four knowledge questions; 32 and 54% reported a history of prior influenza, and 61 and 47% had received at least one influenza vaccination in the past. Vaccination rates for the previous season were 47, 34, 30, 25, and 29% in staff members, primary caretakers, their partners, diseased children, and their siblings, respectively. Main motivations (>75% in ≥ 1 cohort) for vaccination were prevention of influenza disease and concerns to transmit it to others (77–100%) and reasons for not being immunized concerns of adverse effects and use of alternative protection (33–83%). Variables significantly associated with vaccination by multivariate analysis included receipt of influenza vaccinations in the past (OR 2.2–20.5), recommendations by health care providers (OR 4.8–45.5), a lower level of education (caretakers; OR 2.2), and younger age (children; OR 0.9).


The results of this survey indicate insufficient vaccination rates and provide potential approaches for improved vaccination strategies in the setting of pediatric cancer care.


Influenza Children Cancer Transplantation Leukemia Vaccination Immunization rates Adherence Recommendations Staff Parents Caretakers 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


This study was supported by internal funding.

Supplementary material

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Supplemental Table 1 (DOCX 62 kb)
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Supplemental Table 6 (DOCX 60 kb)
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ESM 1 (DOCX 63 kb)
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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Institute of Medical Microbiology – Clinical VirologyUniversity Hospital MünsterMünsterGermany
  2. 2.Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology/OncologyUniversity Children’s Hospital MünsterMünsterGermany

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