COVID-19 Vaccine Hesitancy in Australian Patients with Solid Organ Cancers

Abstract

Background: Vaccination is the cornerstone of the global public health response to the COVID-19 pandemic. Excess morbidity and mortality of COVID-19 infection is seen in people with cancer. COVID-19 vaccine hesitancy has been observed in this medically vulnerable population, although associated attitudes and beliefs remain poorly understood. Methods: An online cross-sectional survey of people with solid organ cancers was conducted through nine health services across Australia. Demographics, cancer-related characteristics and vaccine uptake were collected. Perceptions and beliefs regarding COVID-19 vaccination were assessed using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale and the Disease Influenced Vaccine Acceptance Scale-6. Results: Between June and October 2021, 2691 people with solid organ cancers completed the survey. The median age was 62.5 years (SD = 11.8; range 19–95), 40.9% were male, 71.3% lived in metropolitan areas and 90.3% spoke English as their first language. The commonest cancer diagnoses were breast (36.6%), genitourinary (18.6%) and gastrointestinal (18.3%); 59.2% had localized disease and 56.0% were receiving anti-cancer therapy. Most participants (79.7%) had at least one COVID-19 vaccine dose. Vaccine uptake was higher in people who were older, male, metropolitan, spoke English as a first language and had a cancer diagnosis for more than six months. Vaccine hesitancy was higher in people who were younger, female, spoke English as a non-dominant language and lived in a regional location, and lower in people with genitourinary cancer. Vaccinated respondents were more concerned about being infected with COVID-19 and less concerned about vaccine safety and efficacy. Conclusions: People with cancer have concerns about acquiring COVID-19, which they balance against vaccine-related concerns about the potential impact on their disease progress and/or treatment. Detailed exploration of concerns in cancer patients provides valuable insights, both for discussions with individual patients and public health messaging for this vulnerable population.

Role of Healthcare Professionals and Sociodemographic Characteristics in COVID-19 Vaccination Acceptance among Uro-Oncology Patients: A Cross-Sectional Observational Study

“…Our results showed that 71.7% of participants had received the COVID-19 vaccine, which was significantly higher when compared to the vaccination rate of 48% in the general population in Serbia at the same time [ 10 ]. In contrast to our findings, a study by Bain et al did not show a significant difference in the vaccination rate between oncology patients and the general population in Australia, although the overall vaccination rate in that country was higher [ 11 ]. However, another study conducted in one of the largest oncology centers in Serbia in 2021, which included patients with both solid and hematological malignancies, reported the highest vaccination rate in patients with genitourinary tumors [ 12 ].…”

“…Furthermore, when analyzing the sociodemographic characteristics of our patients, we found that the vaccinated group was significantly older than the unvaccinated group of patients. Our results are consistent with previously published studies that have shown a higher vaccination rate among older people, including oncology patients [ 11 ] and other populations [ 13 ]. This finding is not surprising when knowing that the older population was considered at high risk for severe outcomes of COVID-19 infection, making immunization for this population essential [ 3 ].…”

Vaccination status and attitudes towards COVID-19 vaccination in patients undergoing active cancer treatment in a referral center in Mexico: a survey study

“…In our survey, older age increased the likelihood of having an adequate vaccination status (≥ 3 doses) against COVID-19. Likewise, older age has been repeatedly associated with a higher likelihood of vaccine acceptance among patients with cancer in other studies [12,14,15,[23][24][25][26][27][28][29][30][31][32]. Interestingly, a single-center study in France evaluating acceptance rate of COVID-19 vaccination and vaccine safety among older patients with cancer (≥ 70 years) conducted in January 2021 found a vaccine acceptance rate of 82.6% and an adequate vaccination rate (2 doses) reached 75.3% [33].…”

COVID-19 vaccine hesitancy: assessing the prevalence, predictors, and effectiveness of a community pharmacy based counseling intervention

“…The study by Bongomin et al . focused on high-risk populations, including older adults and multimorbid individuals, with documented vaccine hesitancy, albeit generally low compared to the general population [ 56 – 58 ].…”