Immunogenicity of vaccination against influenza, Streptococcus pneumoniae and Haemophilus influenzae type B in patients with multiple myeloma

Vaccination against influenza and Streptococcus pneumoniae is recommended f or elderly and immunocompromised individuals. However, there is little info rmation concerning the efficacy of vaccination in specific groups of patien ts. In this study, 52 patients underwent vaccination against influenza, S. pneumoniae and Haemophilus influenzae type b (Hib) as they attended hospita l outpatient clinics. Serum was analysed prior to vaccination and 4-6 weeks afterwards. Antibody titres against S. pneumoniae and Hib were compared wi th reference values corresponding to the geometric mean titres of a healthy UK population. For influenza vaccination, haemagglutination inhibition (HI ) titres were measured against three inactivated strains, a titre of greate r than or equal to 1/40 was considered protective. No patient had protectiv e titres to all three antigens prior to vaccination and 41 patients (85%) h ad titres < 1/40 to all 3 strains. Post vaccination only 9/48 patients (19% ) achieved protective antibody titres, Resistance to S. pneumoniae and resp onse to Pneumovax II was also poor: prevaccination, 45 patients (93%) had s uboptimal antibody titres and in 26/43 patients (61%) titres remained low p ost vaccination. Resistance to Hib and response to vaccination was comparab le with the healthy adult UK population. These results question the practic e of routine influenza and pneumococcal vaccination in myeloma patients. (C ) 2000 Cancer Research Campaign.