The coverage of influenza vaccination and predictors of influenza non-vaccination in Danish cancer patients: A nationwide register-based cohort study.

BACKGROUND: Influenza vaccination is recommended and provided free-of-charge to Danish citizens aged ≥65 years and to individuals with acquired immunodeficiency. We aimed to estimate influenza vaccination coverage and investigate predictors of influenza non-vaccination in Danish cancer patients. METHODS: A nationwide cohort study of all Danish citizens aged ≥18 years with an incident cancer diagnosis between 2002 and 2017. Using national registries, we assessed information on influenza vaccination and potential predictors of influenza non-vaccination. We estimated adjusted prevalence ratios (aPR) of influenza non-vaccination for patients aged <65 years and ≥65 years. RESULTS: We observed 269,863 patients during 840,876 influenza vaccination seasons. The influenza vaccination coverage was 14 % for cancer patients <65 years and 51 % for those ≥65 years. No influenza vaccination in the previous season was associated with non-vaccination in the current season (<65 years: aPR = 2.75, 95 %CI = 2.71-2.80; ≥65 years: aPR = 5.15, 95 %CI = 5.10-5.21). Haematological cancer patients receiving chemotherapy had lower vaccination prevalence compared with those not receiving chemotherapy. CONCLUSIONS: The influenza vaccination coverage was low among cancer patients. Influenza non-vaccination in the previous season was the strongest predictor of not receiving influenza vaccination in the current season. Haematological cancer patients on current chemotherapy had lower vaccination prevalence than those not currently receiving chemotherapy.

A longitudinal study of morning, evening, and night light intensities and nocturnal sleep quality in a working population.

We aimed to investigate whether higher light intensity in the morning is associated with better nocturnal sleep quality and whether higher light intensities in the evening or night have the opposite effect. Light intensity was recorded for 7 consecutive days across the year among 317 indoor and outdoor daytime workers in Denmark (55-56° N) equipped with a personal light recorder. Participants reported sleep quality after each nocturnal sleep. Sleep quality was measured using three parameters; disturbed sleep index, awakening index, and sleep onset latency. Associations between increasing light intensities and sleep quality were analyzed using mixed effects models with participant identity as a random effect. Overall, neither white nor blue light intensities during morning, evening, or night were associated with sleep quality, awakening, or sleep onset latency of the subsequent nocturnal sleep. However, secondary analyses suggested that artificial light during the morning and day contrary to solar light may increase vulnerability to evening light exposure. Altogether, we were not able to confirm that higher morning light intensity significantly improves self-reported sleep quality or that higher evening or night light intensities impair self-reported sleep quality at exposure levels encountered during daily life in a working population in Denmark. This suggests that light intensities alone are not important for sleep quality to a degree that it is distinguishable from other important parameters in daily life settings.

Identification of determinants associated with uptake of the first dose of the human papillomavirus vaccine in Denmark.

BACKGROUND: The human papillomavirus vaccine (HPV vaccine) was introduced into the Danish Childhood Vaccination Programme in 2009. Following a national debate questioning the safety of the vaccine, the coverage decreased from an uptake of >90% for the first dose of the HPV vaccine to an uptake of 52% in girls born in 2003. The aim of this study was to identify changes in determinants for HPV vaccine hesitancy in the period when the debate spiraled and to identify determinants for specific hesitancy towards the HPV vaccine among girls who received the second dose of the measles, mumps and rubella vaccine. METHODS: We included girls born in the period 1999-2003 who were residing in Denmark between their 12th and 13th birthday (n = 161,528). Data from the Danish Vaccination Register were linked with demographic data from the Danish Civil Registration System. We used multiple logistic regression models to identify associations between determinants and the uptake of the first dose of the HPV vaccine (HPV1). RESULTS: For girls born in 1999-2000, low uptake was seen in children of increasing birth order, young or old age of mother, non-Danish origin, low uptake of other childhood vaccines, and in girls living with one parent. For girls born in 2001-2003, most of these determinants of low uptake became less significant. Birth order and origin showed different tendencies when comparing birth cohorts 1999-2000 with birth cohorts 2001-2003. CONCLUSIONS: We found demographic disparities in the uptake of HPV1 that were generally in line with existing literature. More importantly, the results indicate that determinants for hesitancy towards the HPV vaccines changed during a period of intense public debate regarding the safety of the HPV vaccine. This may indicate that the public concerns over safety disproportionally affect those who trusted vaccines prior to the debate.