Vaccinating Children After Chemotherapy

Cases with ALL:

Inclusion Criteria:

* Diagnosed with standard, high-risk or very-high risk ALL
* Age at diagnosis: ≥1 year of age (age at enrollment: ≥3 years)
* Completed chemotherapy 3 to 12 months prior to enrollment
* No evidence of ALL relapse or secondary malignancy
* No known primary immunodeficiency
* No receipt of pneumococcal or tetanus-containing vaccines since completing chemotherapy
* No history of allergy to any component of PCV13
* Caregiver and/or participant is English or French-speaking and able to provide written informed consent

Exclusion Criteria:

* Infantile ALL
* Evidence of disease relapse or secondary malignancy
* History of underlying primary immunodeficiency
* Transplant recipient
* Received intravenous immunoglobulin (IVIG) within past 9 months or other blood products within the prior 3 months.Children who received PPV23 within 12 months of enrollment will not be eligible to receive PCV13 or PPV23. These children can still participate in the baseline evaluation, receive DTaP-Hib-IPV vaccine, and have tetanus and pertussis serology measured at 2 and 12-15 months post-immunization.

Controls:

Inclusion criteria

* Children 3-18 years of age, age-matched to cases
* Caregiver and/or participant is English or French-speaking and able to provide written informed consent

Exclusion criteria

* History of primary or secondary immunodeficiency including aplastic anemia, malignancy, nephrotic syndrome, malabsorption or severe malnutrition
* Immunosuppressive therapy within 3 months of enrollment (excluding inhaled corticosteroids)
* Received intravenous immunoglobulin (IVIG) within past 9 months or other blood products within the prior 3 months.