title: Factors associated with influenza vaccination among adult cancer patients: a case-control study.
abstract: Influenza vaccination is recommended for cancer patients; however, adherence is low. We aimed to identify predictive factors for vaccination among cancer patients. We conducted a case-control analysis of a patient cohort in the 2010-2011 influenza season. We included adult cancer patients with solid malignancies undergoing chemotherapy, and haematological patients with active disease. Patients who died between October and November 2010 (N = 43) were excluded from analysis. Cases received the 2011 seasonal influenza vaccine, and controls did not. Data were obtained from patients' records, and validated through personal interviews. We collected socio-demographic information, and data on the malignancy and co-morbidities and triggers for vaccination and non-vaccination. We performed bivariate and multivariable analyses, in which vaccination status was the dependent variable. Of 806 patients included in analysis, 387 (48%) were vaccinated. Variables associated with vaccination on bivariate analysis were older age, higher socio-economic status, lower crowding index, marital status (widowed > married > single), malignancy type (haematological > solid tumours) and time from diagnosis, low-risk malignancy, diabetes, past vaccination, country of birth (non-Russian origin), and physicians' recommendations. Predictive factors found to be independently associated with vaccination on multivariable analysis were past vaccinations, low-risk malignancy, and country of birth. In the analysis conducted among interviewees (N = 561), recommendations from the oncologist (OR 10.7, 95% CI 5.4-21.2) and from the primary-care physician (OR 3.35, 95% CI 2.05-5.49) were strong predictors for vaccination. We conclude that 'habitual vaccinees' continue influenza vaccinations when ill with cancer. Physicians' recommendations, especially the oncologist's, have a major influence on patients' compliance with influenza vaccination.
authors.affiliation: Pharmacy Services, Schneider Children's Medical Centre, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Vinograd
authors.forename: R
authors.initials: R
authors.lastname: Baslo
authors.forename: N
authors.initials: N
authors.lastname: Eliakim-Raz
authors.forename: L
authors.initials: L
authors.lastname: Farbman
authors.forename: A
authors.initials: A
authors.lastname: Taha
authors.forename: A
authors.initials: A
authors.lastname: Sakhnini
authors.forename: A
authors.initials: A
authors.lastname: Lador
authors.forename: S M
authors.initials: SM
authors.lastname: Stemmer
authors.forename: A
authors.initials: A
authors.lastname: Gafter-Gvili
authors.forename: D
authors.initials: D
authors.lastname: Fraser
authors.forename: L
authors.initials: L
authors.lastname: Leibovici
authors.forename: M
authors.initials: M
authors.lastname: Paul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines
keywords: Adherence; chemotherapy; influenza; neoplasm; vaccine