Understanding influenza vaccination rates and reasons for refusal in caregivers and household contacts of cancer patients

Abstract Background Patients with underlying cancer often have suppressed immunity from disease process and cancer therapy, making this population particularly vulnerable to influenza. Few studies have investigated the overall flu vaccination rates; however, little is known regarding the trend of vaccination rates in US cancer survivors and how it varied by individuals’ insurance coverage. Methods We conducted a retrospective cross-sectional study to evaluate the temporal trend of flu vaccination rates using the National Health Interview Survey from 2005 through 2017. Adult cancer survivors (n = 24,381) were included in the analysis. The outcomes were self-reported flu vaccination during the past 12 months with either inactivated or live attenuated nasal vaccine. Insurance coverage was categorized into private (age ≤65), other coverage (age ≤65), uninsured (age ≤65), Medicare and private (age > 65), and other coverage (age > 65). We combined every 2 years data to improve statistical power in the subgroup analysis. Weighted analyses were performed with SAS 9.4 to account for the complex design and NCI-Joinpoint 4.7 was used for joinpoint regression in the trend analysis. Results The overall cancer survivors’ flu vaccination rates improved from 45% in 2005 to 63% in 2017, whereas the cancer-free group improved from 18% in 2005 to 41% in 2017. With cancer survivors, influenza vaccination rates varied remarkably by insurance status (P < 0.001). Elderly survivors (age 65+) with any type of insurance consistently had higher flu vaccination rates than survivors younger than 65 (averaging 70% vs. 40%). For cancer patients age 65 or younger, whether insured or not, the overall flu vaccination rates had improved since 2005. However, for the subgroup who had coverage but not with private insurance, the vaccination rates had been declining since 2012 (50% in 2012/2013 to 45% in 2016/2017). Conclusion Despite the overall increase of flu vaccination rates in both cancer survivors and cancer-free participants since 2005, the growth rate has plateaued since 2015. This is likely related to shifts in healthcare law on the national level. Such impact is particularly significant in cancer patients who are younger and do not have private insurance coverage. Such vulnerable and underserved population will need more resources to help improve their influenza vaccination rate. Disclosures All authors: No reported disclosures.

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Cocoon vaccination for influenza in patients with a solid tumor: a retrospective study

Supportive Care in Cancer ◽

10.1007/s00520-020-05883-2 ◽

2020 ◽

Author(s):

M. J. Rensink ◽

H. W. M. van Laarhoven ◽

F. Holleman

Keyword(s):

Retrospective Study ◽

Influenza Vaccination ◽

Solid Tumor ◽

Viral Infections ◽

Influenza Infection ◽

Vaccination Status ◽

Vaccination Rates ◽

Household Contacts ◽

Oncological Patients ◽

General Dutch Population

Abstract Purpose Oncological patients are susceptible to various severe viral infections, including influenza. Vaccinating oncological patients and their household contacts (“cocoon vaccination”) may protect these patients from contracting influenza. To understand the potential of cocoon vaccination in oncological patients, this study assesses the influenza vaccination status of oncological patients and their household contacts and their considerations regarding the vaccination. Methods In this retrospective study, oncological patients with a solid tumor were asked to fill in a questionnaire about their own and their household contacts’ influenza vaccination status in the influenza season of 2018–2019. Results Ninety-eight patients were included (response rate 88%). The influenza vaccination rates of oncological patients and their first household contacts were 43.9% and 44.9%, respectively. The majority of vaccinated patients and vaccinated first household contacts had been advised by their general practitioner to get the vaccination. A minority of the first household contacts reported getting vaccinated specifically because of the patient’s vulnerability. Unvaccinated patients and unvaccinated household contacts mainly believed the vaccination was unnecessary or were afraid of side effects. None of the included patients had been hospitalized with influenza. Conclusion The oncological patients’ and first household contacts’ vaccination rates in this study were lower than the vaccination rates of the general Dutch population of over 60 years old, possibly due to a lack of knowledge and misconceptions about the vaccination. Further research is required to establish whether cocoon vaccination can contribute to protecting oncological patients from contracting an influenza infection.

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Influenza Vaccination of Household Contacts of Newborns A Hospital-Based Strategy to Increase Vaccination Rates

Infection Control and Hospital Epidemiology ◽

10.1086/656563 ◽

2010 ◽

Vol 31 (10) ◽

pp. 1070-1073 ◽

Cited By ~ 10

Author(s):

Emmanuel B. Walter ◽

Norma J. Allred ◽

Geeta K. Swamy ◽

Anne S. Hellkamp ◽

Rowena J. Dolor

Keyword(s):

Influenza Vaccination ◽

Vaccination Program ◽

Vaccination Rates ◽

Household Contacts

We implemented a hospital-based influenza vaccination program for household contacts of newborns. Among mothers not vaccinated prenatally, 44.7% were vaccinated through the program, as were 25.7% of fathers. A hospital-based program provided opportunities for vaccination of household contacts of newborns, thereby facilitating better adherence to national vaccination guidelines.

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Improving Influenza Vaccination Rates in Hospitalized Asthmatics

PEDIATRICS ◽

10.1542/peds.137.supplement_3.344a ◽

2016 ◽

Vol 137 (Supplement 3) ◽

pp. 344A-344A

Author(s):

Dana Foradori ◽

Huay-ying Lo ◽

Haijun Wang

Keyword(s):

Influenza Vaccination ◽

Vaccination Rates

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Improving Influenza Vaccination Rates For Pediatric Asthmatics By Use Of An Asthma Educational Tool And A Patient Electronic Care System

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2007.12.864 ◽

2008 ◽

Vol 121 (2) ◽

pp. S218-S219

Author(s):

E MARTIN

Keyword(s):

Influenza Vaccination ◽

Educational Tool ◽

Vaccination Rates ◽

Care System

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Correlates of Improved Influenza Vaccination of Healthcare Personnel: A Survey of Hospitals in Louisiana

Infection Control and Hospital Epidemiology ◽

10.1086/670992 ◽

2013 ◽

Vol 34 (7) ◽

pp. 723-729 ◽

Cited By ~ 6

Author(s):

Kayla L. Fricke ◽

Mariella M. Gastañaduy ◽

Renee Klos ◽

Rodolfo E. Bégué

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Influenza Vaccination ◽

Vaccination Campaign ◽

Vaccination Rate ◽

Healthcare Personnel ◽

Patient Contact ◽

Hospital Type ◽

Vaccination Rates ◽

Item Questionnaire

Objective.To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates.Design.Survey.Participants.Volunteer sample of hospitals in Louisiana.Methods.All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate.Results.Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%–91%).Conclusions.The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.

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Influenza Vaccination in Psoriatic Patients—Epidemiology and Patient Perceptions: A German Multicenter Study (Vac-Pso)

Vaccines ◽

10.3390/vaccines9080843 ◽

2021 ◽

Vol 9 (8) ◽

pp. 843

Author(s):

Christian Kromer ◽

Phoebe Wellmann ◽

Ralf Siemer ◽

Selina Klein ◽

Johannes Mohr ◽

...

Keyword(s):

Influenza Vaccination ◽

Inflammatory Diseases ◽

Influenza Virus Infection ◽

Multivariate Regression Analysis ◽

Cross Sectional Study ◽

Patient Perceptions ◽

Cross Sectional ◽

Vaccination Rates ◽

Disease Characteristics ◽

History Of

The risk of developing severe complications from an influenza virus infection is increased in patients with chronic inflammatory diseases such as psoriasis (PsO) and atopic dermatitis (AD). However, low influenza vaccination rates have been reported. The aim of this study was to determine vaccination rates in PsO compared to AD patients and explore patient perceptions of vaccination. A multicenter cross-sectional study was performed in 327 and 98 adult patients with PsO and AD, respectively. Data on vaccination, patient and disease characteristics, comorbidity, and patient perceptions was collected with a questionnaire. Medical records and vaccination certificates were reviewed. A total of 49.8% of PsO and 32.7% of AD patients were vaccinated at some point, while in season 2018/2019, 30.9% and 13.3% received an influenza vaccination, respectively. There were 96.6% and 77.6% of PsO and AD patients who had an indication for influenza vaccination due to age, immunosuppressive therapy, comorbidity, occupation, and/or pregnancy. Multivariate regression analysis revealed higher age (p < 0.001) and a history of bronchitis (p = 0.023) as significant predictors of influenza vaccination in PsO patients. Considering that most patients had an indication for influenza vaccination, the rate of vaccinated patients was inadequately low.

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Structural inequities in seasonal influenza vaccination rates

BMC Public Health ◽

10.1186/s12889-021-11179-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lara I. Brewer ◽

Mark J. Ommerborn ◽

Augustina Le Nguyen ◽

Cheryl R. Clark

Keyword(s):

Primary Care ◽

Health Insurance ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

American Indian ◽

Low Socioeconomic Status ◽

Behavioral Risk ◽

Vaccination Rates ◽

Access To Primary Care ◽

Structural Inequities

Abstract Background Influenza immunization is a highly effective method of reducing illness, hospitalization and mortality from this disease. However, influenza vaccination rates in the U.S. remain below public health targets and persistent structural inequities reduce the likelihood that Black, American Indian and Alaska Native, Latina/o, Asian groups, and populations of low socioeconomic status will receive the influenza vaccine. Methods We analyzed correlates of influenza vaccination rates using the 2019 Behavioral Risk Factor Surveillance System (BRFSS) in the year 2020. Our analysis compared influenza vaccination as the outcome of interest with the variables age, sex, race, education, income, geographic location, health insurance status, access to primary care, history of delaying care due to cost, and comorbidities such as: asthma, cardiovascular disease, hypertension, body mass index, cancer and diabetes. Results Non-Hispanic White (46.5%) and Asian (44.1%) participants are more likely to receive the influenza vaccine compared to Non-Hispanic Black (36.7%), Hispanic (33.9%), American Indian/Alaskan Native (36.6%), and Native Hawaiian/Other Pacific Islander (37.9%) participants. We found persistent structural inequities that predict influenza vaccination, within and across racial and ethnic groups, including not having health insurance [OR: 0.51 (0.47–0.55)], not having regular access to primary care [OR: 0.50 (0.48–0.52)], and the need to delay medical care due to cost [OR: 0.75 (0.71–0.79)]. Conclusion As COVID-19 vaccination efforts evolve, it is important for physicians and policymakers to identify the structural impediments to equitable U.S. influenza vaccination so that future vaccination campaigns are not impeded by these barriers to immunization.

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Regional differences in general practitioners’ behaviours regarding influenza vaccination: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-021-06177-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jonathan Arlt ◽

Kristina Flaegel ◽

Katja Goetz ◽

Jost Steinhaeuser

Keyword(s):

Influenza Vaccination ◽

General Practitioners ◽

Personal Characteristics ◽

Cross Sectional Study ◽

Central Research Institute ◽

World Health ◽

Central Research ◽

Cross Sectional ◽

Vaccination Rates ◽

Health Organization

Abstract Background The World Health Organization recommends vaccination rates of 75% against seasonal influenza for patients over 65 years old. In the 2013/2014 season, the German vaccination rates ranged between 14 and 65%. This study aimed to compare the attitudes, personal characteristics and vaccination behaviours of general practitioners (GPs) in regions with high and low vaccination rates in Germany. Methods In May 2016, a questionnaire was sent to 1594 GPs practising in 16 districts with the highest and the lowest vaccination rates in Western and Eastern Germany as described by the Central Research Institute of Ambulatory Health Care in Germany for the 2013/2014 season. Descriptive statistics and multiple regression analyses were computed to identify potential factors associated with high vaccination rates. Results A total response rate of 32% (515/1594 participants) was observed in the study. GPs reported their attitudes towards vaccination in general and vaccination against influenza as mostly ‘very positive’ (80%, n = 352 and 65%, n = 288, respectively). GPs practising in regions with low vaccination rates reported their attitudes towards vaccinations in general (p = 0.004) and towards influenza vaccination (p = 0.001) more negatively than their colleagues from regions with high vaccination rates. Multiple logistic regression identified an increasing influence of year-dependent changing efficiency on GPs’ influenza rates as the strongest factor for predicting GPs from highly vaccinating regions (OR = 4.31 [1.12–16.60]), followed by the patient’s vaccination refusal despite GP advice due to already receiving a vaccination from another physician (OR = 3.20 [1.89–5.43]) and vaccination information gathering through medical colleagues (OR = 2.26 [1.19–4.29]). Conclusions The results of this study suggest a correlation between GPs’ attitudes and regional vaccination rates. Beneath GPs’ individual attitudes, the regional attitude patterns of patients, colleagues and medical assistants surrounding those GPs seem decisive and should be integrated into future campaigns to increase vaccination rates at a regional level.

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