The recommendation of the Italian Association of Pediatric Hematology and Oncology: to defend the little patients from the severe complications of the infection and allow them to continue cancer treatments and controls
Cancer patients, especially those “in active treatment” or who are undergoing treatment during this period, must be vaccinated as quickly as possible against Covid-19 because they are in greater danger than the rest of the population if they contract the virus. A protection that must be extended even to children diagnosed with cancer, so that they can continue to have regular treatments and checks, which are decisive for having a better chance of recovery. This is what the experts of the Italian Association of Pediatric Hematology and Oncology (Aieop) claim, who have drawn up a specific consensus document for the extension of vaccination first to adolescence (12-17 years) and then to the second and third childhood (5-11 years).
Vaccine aimed at protecting the most vulnerable people
The prognosis of children with cancer has progressively improved over the years and today about 85% of the young patients recover. A great success compared to 58% in the mid-1970s, thanks above all to early diagnoses and the many advances made by scientific research, which must not be endangered by the coronavirus epidemic. “The condition of immunosuppressed, which mainly concerns cancer patients (adults and children) undergoing therapy, is not a contraindication but a further motivation for vaccination – underlines Archangel Priest, president Aieop -, because the vaccine is aimed at protecting the most fragile people. The risk of side effects or adverse reactions, such as myocarditis and pericarditis, is extremely low and in any case lower than the danger linked to the evolution of the disease caused by the virus “. Every year in Italy they get cancer approximately 1,400 children between the ages of 0 and 14 and approximately 800 adolescents up to 19 years. The document prepared by the Aieo Infections and Supportive Therapies Working Group and coordinated by the director of pediatric oncohematology of the integrated university hospital of Verona, Simone Cesaro, highlights that vaccination has an important role in preventing Sars infection -CoV-2 and the resulting disease, to allow the regular performance of chemotherapy or immunosuppressive treatments and checks or hospital admissions, finally, to prevent treatment delays.
When to vaccinate children
The community of Italian oncohematological pediatricians recognizes that patients suffering from oncological pathologies, primary or secondary immunodeficiencies and cytopenias of autoimmune origin or bone marrow failure represent a broad category of frail children. And in the consensus document it is indicated that the choice of when to carry out the vaccination, for an oncohematological patient under treatment, must be personalized on the basis of the intensity of care and the type of treatment in place, taking into consideration a series of variables. «Generally speaking the time of vaccination for children who are undergoing therapies or who have just undergone a transplant, must be agreed from time to time with the treating doctor, evaluating the individual case from time to time “. To protect small cancer patients as much as possible, of course, Aieop specialists recommend vaccination of parents and close family members and the maintenance of individual and social protection measures such as the use of a mask, hand hygiene and physical or social distancing, which remain the cornerstones of prevention of Sars-CoV-2 infection. As well as annual flu vaccination it remains a recommended preventive measure for the patient and family members.
The risks for children who contract Covid
If it is true that the incidence of Covid in Italian pediatric onco-hematology centers has so far been limited (the observed course has mostly been favorable, with only 3% of cases requiring hospitalization in intensive care and no deaths attributed to the disease over the course of the various pandemic waves), global data shows that the virus can have a severe course in cancer patients, both adults and children. In the Global Covid-19 Registry, in the period 15 April 2020-1 February 2021, 1,520 pediatric oncohematological patients with Sars-CoV-2 were registered, of which 1,319 (87%) with a minimum follow-up of 30 days. 30.5% of patients were asymptomatic, while 67.4% were hospitalized. 55.8% changed their cancer treatment following infection. Severe or very severe forms were 19.9% while the mortality due to the infection was 3.8%. “As many studies at an international level have now shown – concludes the president Aieop – cancer patients, even in children, have a higher risk of developing severe forms of Covid and facing severe complications, which also increase their their likelihood of virus-related mortality. They are people with a greater susceptibility to respiratory infections, with an immune system compromised by courses of chemotherapy and radiotherapy, or completely suppressed, as is essential for transplant procedures. And that, in addition, they need frequent access to hospital facilities for visits and treatments. In light of the highly contagious variants of the virus (such as Omicron), pediatric oncohematological patients therefore have a priority indication for vaccination“.
January 11, 2022 (change January 11, 2022 | 14:10)
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