Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Introduction: The CDC recommends that patients with solid tumors should receive their annual influenza vaccine. This recommendation is stronger for patients aged 65 and older, who should receive the high dose or adjuvanted influenza vaccine formulation. However, there is currently no published data about influenza vaccine uptake in patients aged 65 and older with head and neck cancer. We sought to investigate use of influenza vaccines in the year immediately before and after diagnosis of head and neck cancer aged above 65.
Methods: This was a retrospective cohort study utilizing the SEER-Medicare data resource. Patients above age 65 who were diagnosed with head and neck squamous cell carcinoma between 2011-2015 were included in our study. Medicare Part B claims data was used to determine influenza vaccine usage.
Results: A total of 7149 patients met our inclusion criteria. Of these, 2383 (33.3%) were female and mean age at diagnosis was 73.61 (SD 9.02). In total, 2841 (34.7%) patients got at least one flu vaccine in the time from one year before to one year after their cancer diagnosis. In the one year before diagnosis, 27.5% of patients had at least one influenza vaccine compared to 30.4% in the one year after (p<0.001). Overall survival was similar between those who received one or more vaccine compared to those who received no vaccines (2 year survival 0.899 in no vaccine group vs. 0.903 in 1+ vaccine group, p=0.72). Compared to those who did not receive vaccines, patients who received 1 or more vaccines were slightly older (mean age 74.99 vs 72.69, p<0.001) and more likely to be female (36.7% vs. 31.1%, p<0.001). In the year following cancer diagnosis, the most common time for vaccination was between 0-30 days after diagnosis (10.4% of vaccines) and the least common time for vaccination was between 60-90 days after diagnosis (6.81% of vaccines, p=0.005).
Conclusion: Even though cancer patients are recommended to receive annual influenza vaccine, less than one third of patients above age 65 diagnosed with head and neck squamous cell carcinoma received their annual influenza vaccine within one year of diagnosis. Those that received vaccinations were more likely to be female and older. The most common time after diagnosis to receive vaccination was in the first 30 days. More research is warranted into the use of influenza vaccination and its effects in this population.