Attitude towards and experience with SARS-CoV-2 vaccination among German cancer patients.

Abstract

e18603 Background: Cancer patients (pts) were among the first to receive vaccination against SARS-CoV-2 (vac). However, their attitude towards as well as experience with vac remain unclear. Methods: Between 04-11/2021 cancer pts at our university cancer center completed a baseline (BL) and follow-up (FU) questionnaire (Q) containing multiple choice questions and ten eleven-level Likert items ranging from 1 (“totally disagree”) to 11 (“totally agree”). Data was analyzed using Student’s t-test or Chi-square test. Results: 219 pts (43% female) completed BLQ (110 FUQ). Mean age was 64 (24-87) years. 82% had solid tumors, 93% were on active therapy (80% chemotherapy). 4% had history of COVID-19. 78% had already received at least one vac at BL, mainly BNT162b2 (91%) or ChAdOx1-S (8%). Only 1% refused vac. Most pts completely agreed to “definitely get vaccinated” (82%) and completely disagreed with “vac is dispensable due to COVID-19 being no serious threat” (82%; more dissent among men, p = 0.037) or “being against vaccination in general” (81%). Self-assessment as member of a risk group (p = 0.03) and fear of COVID-19 (p = 0.002) were more common among women. Every third patient (31%) completely agreed to “being afraid of COVID-19”, every second thinks “SARS-CoV-2 infection would be very dangerous” (56%). Only 41% expressed “complete confidence in the vaccine being safe” and 37% “not being afraid of side effects”. Fear of side effects (SE) was more common among women (p = 0.0016), pts with solid tumors (p = 0.05), with GI tumors (p < 0.0001) and below mean age (p = 0.006). The latter expressed less “confidence in the vaccine being safe” (p = 0.0029). At FUQ, most pts (91%) reported their vac to be well tolerated, 44% reported no SE, especially men (p = 0.001) and pts above age average (p = 0.002). Most common SE was local pain at injection site (36%), which was more frequent among women (p = 0.002), younger pts (p = 0.024) and pts with solid tumors (p = 0.04). Other common SE included fatigue (18%) and myalgia (8%). No thromboembolic events occurred. Only 3 pts had their therapy postponed due to SE. Almost all pts felt retrospectively sufficiently informed about vac and possible SE (94%), would have it again (88%) and agree to get it yearly, if recommended (78%). After vac, pts felt safe meeting friends or family (91%) or shopping (62%). Vacation (32%), work (22%), public transport (21%) or sports (19%) were considered less safe (less frequent among men, p < 0.05). Most pts (70%) did not feel that the COVID-19 pandemic negatively influenced their treatment and regarded the hospitals protective measures as adequate (91%). Conclusions: Willingness to get vac is high among cancer pts and vac is well tolerated in this sensitive cohort. However, concerns about vac safety remain an issue. Those as well as gender differences need to be addressed to increase vac rates and tolerability. The present results may help identify pts that benefit from more detailed pre-vac consultation.

Prevalence and Assessment of Factors Associated with COVID-19 Vaccine Hesitancy in an Ethnic Minority Oncology Patient Population

“…Although a majority of cancer patients such as those in our study are vaccinated, which is consistent with prior reports [ 29 , 30 , 32 , 41 , 42 , 43 ], cancer patients have been an under-represented group in vaccine clinical trials, especially ethnic minorities. Therefore, it may be justified for these patients to have safety concerns and skepticisms.…”

“…In our study on cancer patients, 95% of the respondents were either Black or Hispanic, with 65% vaccinated and actively receiving treatment for their cancer during the crucial time of the initial rollout of COVID-19 vaccines in New York City. Overall, a large majority of our patients—79%—perceived that COVID-19 was risky and dangerous, and 65% considered the vaccines to be safe, similar to prior results in cancer patient studies [ 25 , 28 , 29 , 30 , 33 , 35 , 41 , 42 , 43 , 44 ]. Other self-reported reasons for being vaccinated stated by our participants included protecting themselves, family, and friends, the collective good of ending the pandemic, and trust in the vaccine and science; again, these were very similar to previous studies in cancer patients and ethnic minorities [ 23 , 25 , 28 , 29 , 31 , 35 , 50 ].…”

“…In contrast, when examining those who were unvaccinated or refused the vaccine, their main reasons were concerns about side effects (71%), that it was not needed (57%), and mistrust in the science of the vaccine (14%), which are similar to results from other studies [ 25 , 28 , 29 , 30 , 33 , 35 , 40 , 42 , 43 , 44 ]. Among participants who answered that COVID-19 was not harmful (21% of the total, n = 11), 64% remained unvaccinated at the time of the initial survey.…”

“…This concern is further amplified if a patient with COVID-19 is not only unvaccinated but also has comorbidities such as cancer, predisposing them to higher risk of morbidity and mortality. COVID-19 vaccine hesitancy has been studied previously in cancer patients worldwide [ 25 , 26 , 27 , 28 , 29 , 30 , 32 , 39 , 40 , 41 , 42 , 43 , 44 ] and in the United States [ 31 , 33 , 35 , 36 , 45 ], including multiple studies of ethnic minorities in the US [ 21 , 22 , 23 , 24 , 46 , 47 , 48 , 49 , 50 , 51 ], but no known research exists specifically examining ethnic minority cancer patients and their views on the COVID-19 vaccine. This study helps address this gap in the knowledge by uniquely examining two different time-points of vaccination status 6-months post-initial survey, employing a vaccine knowledge score composite and exploring a brief educational intervention to raise patients’ awareness, to gain valuable insight into this distinctly disadvantaged population in the US.…”

Adherence to Sars-CoV2 vaccination in hematological patients

“…Only 53.7% reported their intent to be vaccinated as soon as the vaccine becomes available, 29.7% considered they were not ready yet but likely to change their mind and 16.6% definitely refused vaccination (9). Later surveys of cancer patients conducted in 2021 also assessed patient attitudes towards vaccination and reported hesitancy or refusal rates ranging from only 6% refusal to 74% hesitancy/refusal at various periods and in various countries (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Besides the large survey of patients with blood cancers already discussed (5), very few surveys specifically analyzed hematologic patients such as patients (n=147) with sickle cell anemia (23) or parents of children (n=113) undergoing hematopoietic transplantation (24).…”