Skip to main content

Advertisement

SpringerLink
Log in

Influenza vaccination among cancer survivors: disparities in prevalence between blacks and whites

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Introduction

Cancer survivors are at increased risk for influenza-related complications. Racial disparities in preventive health services have not been extensively studied among cancer survivors. Our objective is to compare influenza vaccination prevalence among black and white cancer survivors

Methods

We performed a secondary data analysis of 41,346 white and black cancer survivors (excluding non-melanoma skin cancer) from the 2009 Behavioral Risk Factor Surveillance System survey. Respondents were asked whether they had received an influenza vaccination in the previous year. Multivariable logistic regression was used to estimate the odds of having influenza vaccine by race.

Results

Sixty-five percent of whites reported receiving the vaccine in the last year compared to 50 % of blacks. Blacks had significantly lower odds of vaccination after controlling for covariates significantly associated with the odds of influenza vaccination. Higher education, having health insurance, having a primary care provider, and having a routine check-up in the last year increased the odds of receiving an influenza vaccine.

Conclusions

Our analysis supports that racial disparities in vaccine coverage persist among cancer survivors, a group strongly recommended to receive annual influenza vaccine, even when predictors significantly associated with increased vaccination are controlled for.

Implications for Cancer Survivors

As a nationally representative survey with a large sample size, our study provides a picture of self-reported vaccine coverage among cancer survivors in the USA and the disparity that exists between blacks and whites in this population. Care teams can use these findings to better target follow-up care for cancer survivors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. Seasonal influenza. http://www.cdc.gov/flu/about/qa/disease.htm. Accessed 11 Sep 2012.

  2. Centers for Disease Control and Prevention (CDC). Updated estimates of mortality associated with seasonal influenza through the 2006–2007 influenza season. MMWR Morb Mortal Wkly Rep. 2010;59(33):1057–62.

    Google Scholar 

  3. Molinari N, Ortegasanchez I, Messonnier M, Thompson W, Wortley P, Weintraub E, et al. The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine. 2007;25(27):5086–96. doi:10.1016/j.vaccine.2007.03.046.

    Article  PubMed  Google Scholar 

  4. Tosh PK, Jacobson RM, Poland GA. Influenza vaccines: from surveillance through production to protection. Mayo Clin Proc. 2010;85(3):257–73. doi:10.4065/mcp.2009.0615.

    Article  PubMed  CAS  Google Scholar 

  5. Glezen WPGS, Atmar RL, Piedra PA, Couch RB. Impact of respiratory virus infections on persons with chronic underlying conditions. JAMA. 2000;283:499–505.

    Article  PubMed  CAS  Google Scholar 

  6. Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, Ruhl J, Howlader N, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Cronin K, Chen HS, Feuer EJ, Stinchcomb DG, Edwards BK (eds). SEER cancer statistics review, 1975–2007. Bethesda: National Cancer Institute. http://seer.cancer.gov/csr/1975_2007/, based on November 2009 SEER data submission, posted to the SEER web site, 2010. Accessed 11 Sep 2012.

  7. Warren JL, Mariotto AB, Meekins A, Topor M, Brown ML. Current and future utilization of services from medical oncologists. J Clin Oncol. 2008;26(19):3242–7. doi:10.1200/jco.2007.14.6357.

    Article  PubMed  Google Scholar 

  8. Centers for Disease Control and Prevention (CDC). Cancer survivors - United States, 2007. MMWR Morb Mortal Wkly Rep. 2011;60(9):269–96.

    Google Scholar 

  9. Centers for Disease Control and Prevention. Cancer, the flu, and you. http://www.cdc.gov/cancer/flu/. Accessed 11 Sep 2012.

  10. McBean A. The use of preventive health services among elderly uterine cancer survivors. Am J Obstet Gynecol. 2008;198(1):86.e1–e8. doi:10.1016/j.ajog.2007.05.036.

    Article  Google Scholar 

  11. Fairley TL Hawk H, Pierre S. Health behaviors and quality of life of cancer survivors in Massachusetts, 2006: data for comprehensive cancer control. Prev Chronic Dis. 2010;7(1):A09 http://www.cdc.gov/pcd/issues/2010/jan/09_0062.htm. Accessed 11 Sep 2012.

  12. Snyder CF, Frick KD, Peairs KS, Kantsiper ME, Herbert RJ, Blackford AL, et al. Comparing care for breast cancer survivors to non-cancer controls: a five-year longitudinal study. J Gen Intern Med. 2009;24(4):469–74. doi:10.1007/s11606-009-0903-2.

    Article  PubMed  Google Scholar 

  13. Institute NC. Incidence and mortality rates by age. 2007.

  14. U.S. Department of Health and Human Services. Healthy people 2020. http://www.healthypeople.gov/2020/about/DisparitiesAbout.aspx. Accessed 11 Sep 2012.

  15. U.S. Department of Health and Human Services. Healthy people 2020. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=23. Accessed 11 Sep 2012.

  16. Ompad D, Galea S, Vlahov D. Distribution of influenza vaccine to high-risk groups. Epidemiol Rev. 2006;28:54–70.

    Article  PubMed  Google Scholar 

  17. Linn ST, Guralnik JM, Patel KV. Disparities in influenza vaccine coverage in the United States, 2008. J Am Geriatr Soc. 2010;58(7):1333–40. doi:10.1111/j.1532-5415.2010.02904.x.

    Article  PubMed  Google Scholar 

  18. Findley P, Sambamoorthi U. Preventive health services and lifestyle practices in cancer survivors: a population health investigation. J Cancer Surviv. 2009;3(1):43–58. doi:10.1007/s11764-008-0074-x.

    Article  PubMed  Google Scholar 

  19. Shih Y-CT, Pan IW. Influenza vaccination among individuals with cancer and their family members. Am J Prev Med. 2010;38(1):61–9. doi:10.1016/j.amepre.2009.09.032.

    Article  PubMed  Google Scholar 

  20. Snyder CF, Earle CC, Herbert RJ, Neville BA, Blackford AL, Frick KD. Trends in follow-up and preventive care for colorectal cancer survivors. J Gen Intern Med. 2008;23(3):254–9. doi:10.1007/s11606-007-0497-5.

    Article  PubMed  Google Scholar 

  21. Fiscella K. Commentary - anatomy of racial disparity in influenza vaccination. Health Serv Res. 2005;40(2):539–50.

    Article  PubMed  Google Scholar 

  22. Centers for Disease Control and Prevention. Behavioral risk factor surveillance system 2009 survey overview. http://www.cdc.gov//brfss/technical_infodata/surveydata/2009.htm. Accessed 11 Sep 2012.

  23. Centers for Disease Control and Prevention. Behavioral risk factor surveillance survey 2009 summary data quality report. http://www.cdc.gov/BRFSS/technical_infodata/quality.htm. Accessed 11 Sep 2012.

  24. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System 2009 Summary Data Quality Report. http://www.cdc.gov/BRFSS/technical_infodata/quality.htm. Accessed 11 Sep 2012.

  25. Centers for Disease Control and Prevention (CDC). Racial/ethnic disparities in influenza and pneumococcal vaccination levels among persons aged ≥65 years - United States, 1989–2001. MMWR Morb Mortal Wkly Rep. 2003;52(40):958–62.

    Google Scholar 

  26. Gornick ME, Eggers PW, Reilly TW, Mentnech RM, Fitterman LK, Kucken LE, et al. Effects of race and income on mortality and use of services among Medicare beneficiaries. N Engl J Med. 1996;335(11):791–9. doi:10.1056/NEJM199609123351106.

    Article  PubMed  CAS  Google Scholar 

  27. Fiscella K, Dressler R, Meldrum S. Impact of influenza vaccination disparities on elderly mortality in the United States. Prev Med. 2007;45:83–7.

    Article  PubMed  Google Scholar 

  28. Hebert P, Frick K, Kane R, McBean A. The causes of racial and ethnic differences in influenza vaccination rates among elderly Medicare beneficiaries. Health Serv Res. 2005;40(2):517–37.

    Article  PubMed  Google Scholar 

  29. Setse RW, Euler GL, Gonzalez-Feliciano AG, Bryan LN, Furlow C, et al. Influenza vaccination coverage - United States, 2000–2010. MMWR Surveill Summ. 2011;60(Suppl):38–41.

    PubMed  Google Scholar 

  30. Centers for Medicare and Medicaid Services. Immunizations. https://www.cms.gov/AdultImmunizations/02_Providerresources.asp. Accessed 11 Sep 2012.

  31. Winston CA, Wortley PM, Lees KA. Factors associated with vaccination of Medicare beneficiaries in five U.S. communities: results from the racial and ethnic adult disparities in Immunization Initiative survey, 2003. J Am Geriatr Soc. 2006;54(2):303–10. doi:10.1111/j.1532-5415.2005.00585.x.

    Article  PubMed  Google Scholar 

  32. Hewitt M, Greenfield S, Stovall E, editors. From cancer patient to cancer survivor: lost in transition. Washington, DC: Institute of Medicine and National Research Council; 2006.

    Google Scholar 

  33. Shenson D, DiMartino D, Bolen J, Campbell M, Lu P-J, Singleton JA. Validation of self-reported pneumococcal vaccination in behavioral risk factor surveillance surveys: experience from the sickness prevention achieved through regional collaboration (SPARC) program. Vaccine. 2005;23(8):1015–20. doi:10.1016/j.vaccine.2004.07.039.

    Article  PubMed  Google Scholar 

  34. Zimmerman RK, Raymund M, Janosky JE, Nowalk MP, Fine MJ. Sensitivity and specificity of patient self-report of influenza and pneumococcal polysaccharide vaccinations among elderly outpatients in diverse patient care strata. Vaccine. 2003;21(13–14):1486–91. doi:10.1016/s0264-410x(02)00700-4.

    Article  PubMed  Google Scholar 

Download references

Grant support

The work reported in this paper was supported by the Baltimore VA Medical Center Geriatric Research, Educational and Clinical Center, the Claude D. Pepper Older Americans Independence Center 5 P30 AG028747 07, and the Clinical Research Curriculum Award 8 K30 TR000106 08 (Sorkin).

Conflicts of interest

The authors declare they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood Street, Suite 100 Howard Hall, Baltimore, MD, 21201, USA

    Kristen A. Stafford & Eileen K. Steinberger

  2. Department of Veterans Affairs, Geriatric Research, Education, and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, 21201, USA

    John D. Sorkin

  3. Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    John D. Sorkin

Authors
  1. Kristen A. Stafford
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John D. Sorkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eileen K. Steinberger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eileen K. Steinberger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stafford, K.A., Sorkin, J.D. & Steinberger, E.K. Influenza vaccination among cancer survivors: disparities in prevalence between blacks and whites. J Cancer Surviv 7, 183–190 (2013). https://doi.org/10.1007/s11764-012-0257-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-012-0257-3

Keywords

Search

Navigation