SIR—Nichols et al. [1] recently reported the experience of the Fred Hutchinson Cancer Research Center in the management of influenza infection in hematopoietic stem cell transplant (HSCT) recipients during 12 consecutive respiratory-virus infection seasons. Of note, only 62 (1.3%) of the 4797 patients who underwent transplantation during this period had influenza diagnosed within 120 days after transplantation. Because the patients were not vaccinated during this period, the authors attributed this low incidence to hospital practices and good vaccine coverage of health care workers (HCWs) and family caregivers. Worldwide HCW compliance with influenza vaccination recommendations has been disappointing, varying from 2% to 36% [2]. At the Clinical Hospital of the University of São Paulo, Brazil, we observed a compliance rate of 34.4% in a recent survey of HCWs who manage high-risk patients. Since 2000, Brazil has showed influenza vaccine coverage rates similar to those of many countries in western Europe [3], which reflects the successful efforts of the Brazilian Health Ministry in vaccination campaigns among elderly patients (82.1% coverage in 2003) but not in other high-risk populations [4].
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Clarisse Martins Machado (2005) studied this question.