儿童在化疗后失去疫苗诱导的保护，特别容易患上疫苗可预防的疾病。然而，再接种指南存在差异，且往往缺乏治疗后的再接种。我们对患有血液肿瘤的儿童进行了一项回顾性研究，以评估治疗结束前后的疫苗免疫力，并确定当前的机构再接种计划是否基于疫苗血清学结果跟踪有效。从医院病历中提取2015年4月至2021年7月期间所有接受化疗的儿童的数据进行分析。对白喉、破伤风、肺炎链球菌、b 型流感嗜血杆菌 (Hib)、麻疹、水痘和乙型肝炎的血清抗体水平和疫苗接种时间进行了评估。我们纳入了 31 名患者（中位年龄为 9 岁）。在癌症诊断时，90% 的儿童能够预防破伤风、白喉和麻疹； 65% 至 67% 的人能够预防肺炎球菌和水痘；化疗结束时，67% 至 71% 的患者可预防破伤风、水痘和麻疹；25% 的患者可预防乙型肝炎。 40% 的人仍能预防乙型肝炎；对肺炎球菌和白喉的抑制率为 27% 至 33%。治疗结束后，患者在不同时间重新接种疫苗，但不是系统性的。在治疗后的第一年，20% 至 25% 的儿童仍然无法预防肺炎球菌、麻疹和乙型肝炎，三分之一的儿童无法预防白喉，但所有人都可以预防破伤风和水痘。基于癌症后的有效个体化疫苗接种计划对血清学结果的评估应伴有适当的血清学追踪方法和随访，以评估是否需要加强剂量。我们的研究支持在癌症诊断时和治疗后 3 个月时为所有儿童接种一剂 13 价肺炎球菌结合物，并使用白喉-破伤风-无细胞百日咳/脊髓灰质炎疫苗/乙型肝炎病毒加或减 Hib 和 13 价联合疫苗肺炎球菌结合疫苗和脑膜炎球菌疫苗，包括麻疹/腮腺炎/风疹-水痘带状疱疹病毒疫苗（如果存在良好的免疫重建）。版权所有 © 2023 作者。由 Wolters Kluwer Health, Inc. 出版

Children lose their vaccine-induced protection and are particularly vulnerable to vaccine-preventable diseases after chemotherapy. However, revaccination guidelines are heterogeneous, and there is often a lack of revaccination post-treatment.We conducted a retrospective study of children with hematologic cancer to evaluate vaccine immunity before and after the end of treatment and to determine whether the current institutional revaccination program based on vaccine serology results was followed and effective.Data of all children treated by chemotherapy between April 2015 and July 2021 were extracted from hospital medical records for analysis. Serum antibody levels and time of vaccination were evaluated for diphtheria, tetanus, Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), measles, varicella, and hepatitis B.We included 31 patients (median age, 9 years). At cancer diagnosis, 90% of children were protected against tetanus, diphtheria, and measles; 65% to 67% were protected against pneumococcus and varicella; and 25% against hepatitis B. At the end of chemotherapy, 67% to 71% of patients were protected against tetanus, varicella, and measles; 40% remained protected against hepatitis B; and 27% to 33% against pneumococcus and diphtheria. Patients were revaccinated at various times after the end of treatment but not systematically. During the first-year post-treatment, 20% to 25% of children remained unprotected against pneumococcus, measles, and hepatitis B, one third against diphtheria, but all were protected against tetanus and varicella.An effective individualized vaccination program post-cancer based on serology results should be accompanied by an appropriate serology tracking method and follow-up to assess if booster doses are necessary. Our study supports vaccinating all children with a dose of the 13-valent pneumococcal conjugate at cancer diagnosis and at 3 months post-treatment with the combined diphtheria-tetanus-acellular pertussis/poliomyelitis vaccine/hepatitis B virus plus or minus Hib and 13-valent pneumococcal conjugate and meningococcal vaccine, including measles/mumps/rubella-varicella zoster virus vaccine if good immune reconstitution is present.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.