(390) An Analysis of solid tumor oncology patients’ respiratory vaccination rates in accordance with ASCO guidelines

Background: : Cancer is a complex disease, requiring management that very often extends well beyond just treating the malignancy itself. Patients with cancer often experience compromised immune systems due to a variety of factors including disease progression leading to chronic inflammation and/or direct cancer treatments that impair the immune system. As a result, patients are often at a higher risk of infection making addressing vaccine preventable diseases paramount. In 2024, ASCO updated their guidelines on vaccine recommendations in oncology patients.

Objective: : To describe vaccination rates for respiratory diseases in patients with solid tumor malignancies in accordance with ASCO guidelines.

Methods: : A retrospective, cohort analysis was conducted using the Optum CDM. Adult patients (> 18 years), unless otherwise specified by ASCO guidelines (RSV > 60 years, Pneumococcal > 19 years), with an ICD-10-CM diagnosis code for a solid tumor malignancy as the index event (breast, colon, lung, prostate) between 4/1/2023 and 3/31/2024 were included. For each index event within each of the four solid tumor types, a vaccine specific pre/post index event period was identified looking for a claim representing administration of each of the 4 respiratory vaccinations (Influenza, COVID-19, RSV, Pneumococcal) using 2024 ASCO recommendations as guidance.

Results: : We identified the following number of patients with each solid tumor malignancy: Breast (BC) (n=259,182), Colorectal (CRC) (n=68,704), Lung (LC) (n=97,699), and Prostate (PC) (n=296,700). For those with BC, rates were 27% for Flu, 40% for COVID-19, 18% for RSV, and 26% for Pneumococcal. For those with CRC, rates were 24% for Flu, 33% for COVID-19, 13% for RSV, and 23% for Pneumococcal. For those with LC, rates were 28% for Flu, 36% for COVID-19, 18% for RSV, and 27% for Pneumococcal. For those with PC, rates were 15% for Flu, 43% for COVID-19, 20% for RSV, and 27% for Pneumococcal. Highest overall rates for malignancy, vaccination, and malignancy/vaccination combination were LC at 27%, COVID-19 at 38%, and PC/COVID-19 at 43%. Lowest overall rates for malignancy, vaccination, and malignancy/vaccination combination were CRC at 24%%, RSV at 17%, and CRC/RSV at 13%.

Conclusions: : This analysis shows that there is a significant gap in care for this vulnerable population. This is likely due to a combination of factors including but not limited to discordant care, vaccine hesitancy, patient and provider awareness, and others. Additional research is likely necessary to better understand this patient population, barriers, and strategies to improve vaccination rates.

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