Concerns related to the interactions between COVID-19 vaccination and cancer/cancer treatment were barriers to complete primary vaccination series among Chinese cancer patients: A multicentre cross-sectional survey

Lei Zhang; Jianzhou Yang; Rila Su; Xiaofan Du; Yuxiao Wang; Siyu Chen; Paul Shing-Fong Chan; Zixin Wang; Junjie Xu

doi:10.1080/21645515.2023.2222648

Concerns related to the interactions between COVID-19 vaccination and cancer/cancer treatment were barriers to complete primary vaccination series among Chinese cancer patients: A multicentre cross-sectional survey

Hum Vaccin Immunother. 2023 Aug 1;19(2):2222648. doi: 10.1080/21645515.2023.2222648. Epub 2023 Jun 14.

Authors

Lei Zhang¹, Jianzhou Yang², Rila Su^{3

4}, Xiaofan Du⁵, Yuxiao Wang⁶, Siyu Chen⁷, Paul Shing-Fong Chan⁷, Zixin Wang⁷, Junjie Xu¹

Affiliations

¹ Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong Province, China.
² Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China.
³ Cancer Center at Inner Mongolia People's Hospital, Hohhot, Inner Mongolia Autonomous Region, China.
⁴ John Hopkins Bloomberg School of Public Health, Baltimore, USA.
⁵ Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
⁶ Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong Province, China.
⁷ JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.

Abstract

COVID-19 vaccination is effective for cancer patients without safety concerns. However, COVID-19 vaccination hesitancy is common among cancer patients. This study investigated factors affecting primary COVID-19 vaccination series completion rate among cancer patients in China. A multicentre cross-sectional study was conducted in four Chinese cities in different geographic regions between May and June 2022. A total of 893 cancer inpatients provided written informed consent and completed the study. Logistic regression models were fitted. Among the participants, 58.8% completed the primary COVID-19 vaccination series. After adjusting for background characteristics, concerns about interactions between COVID-19 vaccination and cancers/cancer treatment (adjusted odds ratios [AOR]: 0.97, 95%CI: 0.94, 0.99) were associated with lower completion of primary vaccination series. In addition, perceived higher risk of COVID-19 infection comparing to people without cancers (AOR: 0.46, 95%CI: 0.24, 0.88), perceived a high chance of having severe consequences of COVID-19 infection (AOR: 0.68, 95%CI: 0.51, 0.91) were also associated with lower completion rate. Being suggested by significant others (AOR: 1.32, 95%CI: 1.23, 1.41) and perceived higher self-efficacy to receive COVID-19 vaccination (AOR: 1.48, 95%CI: 1.31, 1.67) were positively associated with the dependent variable. Completion rate of primary COVID-19 vaccination series was low among Chinese cancer patients. Given the large population size and their vulnerability, this group urgently needs to increase COVID-19 vaccination coverage. Removing concerns about interactions between COVID-19 vaccination and cancers, using fear appeal approach, involving significant others, and facilitating patients to make a plan to receive COVID-19 vaccination might be useful strategies.

Keywords: COVID-19 vaccination; Cancer patients; China; media influence; perceptions; primary vaccination series.

Publication types

Multicenter Study

MeSH terms

Asian People
COVID-19 Vaccines
COVID-19* / epidemiology
COVID-19* / prevention & control
Cross-Sectional Studies
Humans
Neoplasms* / complications
Neoplasms* / therapy
Vaccination
Vaccination Hesitancy

Substances

COVID-19 Vaccines

Grants and funding

This work was supported by the Joint Foundation of Innovative Environment Construction of Autonomous Region of Xinjiang (#2019D01C326), The Four “Batches” Innovation Project of Invigorating Medical through Science and Technology of Shanxi Province (2022XM45), the National Natural Science Foundation of China (81872674), and the Shenzhen Science and Technology Innovation Committee Projects (No. JCYJ20220818102817038), the Scientific Research Foundation of Peking University Shenzhen Hospital (No. KYQD2022216). The funder had no role in study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.