Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Exploring factors influencing COVID-19 vaccine hesitancy among people with cancer: a qualitative analysis.   (#16)

Bryan Chan 1 2 , Tammie ST Choi 3 , Lisa Grech 4 , Alastair Kwok 4 5 , Kate Webber 4 5 , Jennifer Wong 4 6 , Mike Nguyen 4 5 , Nathan Bain 5 , Daphne Day 4 5 , Amelia McCartney 4 5 , Ruby Hamer 4 , Eva Segelov 4 5
  1. Department of Oncology, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
  2. School of Medicine and Dentistry, Griffith University, Birtinya, QLD, Australia
  3. Department of Nutrition, Dietetics and Food, Monash University, Clayton, VIC, Australia
  4. Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
  5. Department of Oncology, Monash Health, Clayton, VIC, Australia
  6. Department of Diabetes and Vascular Medicine, Monash Health, Clayton, VIC, Australia

Aims: People with cancer have increased morbidity and mortality associated with COVID-19 infection. The influence of a person’s cancer diagnosis on COVID-19 vaccine uptake is not well understood. We undertook an in-depth exploration of factors influencing COVID-19 vaccine uptake among those with cancer.

Methods: Adults with cancer were recruited from nine Australian health services to undertake a cross-sectional online survey (June to October, 2021) covering COVID-19 vaccine uptake, vaccine hesitancy, confidence and complacency, and disease-related decision-making impact. Free-text responses were invited regarding thoughts and feelings about the interaction between the participant’s cancer, COVID-19, and vaccination. Qualitative thematic analysis was undertaken using an iterative process with representative verbatim quotes to illustrate the themes.

Results: Of 3560 survey responses, 1248 (35.1%, mean age 62.7 (SD 11.8) years, 58.5% female) provided free-text comments for qualitative analysis. Participants who provided free-text comments were significantly less likely to have received a COVID-19 vaccination, compared to those who did not comment (31.4% and 68.6%, respectively). Five key themes were identified from qualitative analysis: (1) having a chronic illness heightened both perceived susceptibility to and severity of COVID-19; (2) disruption of cancer management was a significant perceived barrier to vaccination; (3) paucity of evidence on COVID-19 vaccine safety (for people with their cancer) compromised the perceived benefits; (4) fear of the unknown greatly reduced motivation to vaccine uptake; and (5) many were left confused about COVID-19 and the vaccine.

Conclusions: This analysis highlights the additional layer of complexity related to COVID-19 vaccination decision-making in people with cancer. An appreciation of higher susceptibility to severe COVID-19 outcomes is balanced against uncertain impact of the vaccine on disease progression and management. Clinician consultation that can address individualised concerns related to the person’s cancer and treatments is important to alleviate concerns and maximise COVID-19 vaccine uptake in people with cancer.