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

Nathan Bain; Mike Nguyen; Lisa Grech; Daphne Day; Amelia McCartney; Kate Webber; Alastair Kwok; Sam Harris; Hieu Chau; Bryan Chan; Louise Nott; Nada Hamad; Annette Tognela; Craig Underhill; Bao Sheng Loe; Daniel Freeman; Eva Segelov; On Behalf Of The Canvaccs Investigators

doi:10.3390/vaccines10091373

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

Vaccines (Basel). 2022 Aug 23;10(9):1373. doi: 10.3390/vaccines10091373.

Authors

Nathan Bain¹, Mike Nguyen^{1

2}, Lisa Grech², Daphne Day^{1

2}, Amelia McCartney^{1

2}, Kate Webber^{1

2}, Alastair Kwok^{1

2}, Sam Harris³, Hieu Chau⁴, Bryan Chan^{5

6}, Louise Nott⁷, Nada Hamad^{8

9

10}, Annette Tognela¹¹, Craig Underhill^{12

13}, Bao Sheng Loe¹⁴, Daniel Freeman^{15

16}, Eva Segelov^{1

2}, On Behalf Of The Canvaccs Investigators

Affiliations

¹ Department of Oncology, Monash Health, Clayton, VIC 3168, Australia.
² Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia.
³ Department of Medical Oncology, Bendigo Health, Bendigo, VIC 3550, Australia.
⁴ Department of Oncology, Latrobe Regional Hospital, Traralgon, VIC 3844, Australia.
⁵ Department of Oncology, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia.
⁶ School of Medicine, Griffith University, Birtinya, QLD 4575, Australia.
⁷ Icon Cancer Centre Hobart, Hobart, TAS 7000, Australia.
⁸ Department of Hematology, St Vincent's Hospital Sydney, Darlinghurst, NSW 2010, Australia.
⁹ School of Clinical Medicine, Medicine & Health, University of New South Wales, Kensington, NSW 2052, Australia.
¹⁰ School of Medicine, University of Notre Dame Australia, Chippendale, NSW 2007, Australia.
¹¹ Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW 2560, Australia.
¹² Border Medical Oncology Research Unit, Albury, NSW 2640, Australia.
¹³ Rural Medical School, University of New South Wales, Albury, NSW 2640, Australia.
¹⁴ The Psychometrics Centre, University of Cambridge, Cambridge CB2 1AG, UK.
¹⁵ Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK.
¹⁶ Oxford Health National Health Service Foundation Trust, Oxford OX3 7JX, UK.

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.

Keywords: COVID-19; cancer; vaccination; vaccine hesitancy.

Grants and funding

This research received no external funding.