Vaccination hesitancy is a threat to herd immunity. Healthcare workers (HCWs) play a key role in promoting Coronavirus disease 2019 (COVID-19) vaccination in the general population. We therefore aimed to provide data on COVID-19 vaccination acceptance/hesitancy among German HCWs. For this exploratory, cross-sectional study, an online survey was conducted in February 2021. The survey included 54 items on demographics; previous vaccination behavior; trust in vaccines, physicians, the pharmaceutical industry and health politics; fear of adverse effects; assumptions regarding the consequences of COVID-19; knowledge about vaccines; and information seeking behavior. Odds ratios with 95% confidence intervals were calculated and chi-square tests were performed. Four thousand five hundred surveys were analyzed. The overall vaccination acceptance was 91.7%. The age group ≤20 years showed the lowest vaccination acceptance. Factors associated with vaccination hesitancy were lack of trust in authorities and pharmaceutical companies. Attitudes among acquaintances were associated with vaccination hesitancy too. Participants with vaccination hesitancy more often obtained information about COVID-19 vaccines via messenger services or online video platforms and underperformed in the knowledge test. We found high acceptance amongst German HCWs. Several factors associated with vaccination hesitancy were identified which could be targeted in HCW vaccination campaigns.

(1) Background: Health care workers (HCWs) play a key role in increasing anti-COVID vaccination rates. Fear of potential side effects is one of the main reasons for vaccine hesitancy. We investigated which side effects are of concern to HCWs and how these are associated with vaccine hesitancy. (2) Methods: Data were collected in an online survey in February 2021 among HCWs from across Germany with 4500 included participants. Free-text comments on previously experienced vaccination side effects, and fear of short- and long-term side effects of the COVID-19 vaccination were categorized and analyzed. (3) Results: Most feared short-term side effects were vaccination reactions, allergic reactions, and limitations in daily life. Most feared long-term side effects were (auto-) immune reactions, neurological side effects, and currently unknown long-term consequences. Concerns about serious vaccination side effects were associated with vaccination refusal. There was a clear association between refusal of COVID-19 vaccination in one’s personal environment and fear of side effects. (4) Conclusions: Transparent information about vaccine side effects is needed, especially for HCW. Especially when the participants’ acquaintances advised against vaccination, they were significantly more likely to fear side effects. Thus, further education of HCW is necessary to achieve good information transfer in clusters as well.

BackgroundVaccination hesitancy is a serious threat to achieve herd immunity in a global and rapidly changing pandemic situation. Health care workers play a key role in the treatment of patients with Coronavirus disease 2019 (COVID-19) and in promoting vaccination in the general population. The aim of the study was to provide data on COVID-19 vaccination acceptance and barriers among healthcare workers in Germany to support health policymakers choosing specific vaccination campaign strategies.MethodsAn online survey was conducted among health care workers in Germany in February 2021. The survey included 55 items on demographics, previous vaccination behavior, trust in vaccines, physicians, pharma industry, and health politics as well as fear of adverse effects, assumptions on disease consequences, knowledge about vaccines, information seeking behavior and a short COVID-19 vaccine knowledge test.ResultsA total of 4500 surveys could be analyzed. The overall vaccination acceptance was 91.7%. The age group ≤20 years showed the lowest vaccination acceptance of all age groups. Regarding professional groups, residents showed the highest vaccination acceptance. Main factors for vaccination hesitancy were lack of trust in authorities and pharmaceutical companies. Personal and professional environment influenced the attitude towards a vaccination too. Participants with vaccination hesitancy were more likely to obtain information about COVID-19 vaccines via messenger services or online video platforms and underperformed in the knowledge test.ConclusionsIn conclusion, we found a high acceptance rate amongst German health care workers. Furthermore, several factors associated with vaccination hesitancy were identified which could be targeted in vaccination campaigns.

Zusammenfassung Hintergrund Diese Studie untersucht aktuelle Bedürfnisse und Belastungen von ambulanten Krebspatienten im Rahmen der COVID-19-Pandemie. Material und Methoden Zwischen 11/2020 und 02/2021 wurden 122 ambulante Krebspatientinnen und -patienten des Comprehensive Cancer Center München in die Studie eingeschlossen und anhand eines standardisierten, halbstrukturierten Interviews zu Wissensstand und Informationsbedürfnissen in Bezug auf COVID-19, Risikowahrnehmung und Sorgen hinsichtlich der ambulanten Krebsbehandlung, COVID-19-spezifischen Belastungen sowie zum Vertrauen in das Gesundheitssystem und der Impfbereitschaft befragt. Zusätzlich wurde psychosozialer Distress anhand des Distress-Thermometers (DT) erhoben. Ergebnisse Über ein Drittel der Krebspatienten (34,2 %, n = 41/120) hatte noch Informationsbedarf hinsichtlich der Auswirkungen des Coronavirus auf ihre Erkrankung oder Behandlung. 17,2 % (n = 21/122) waren von Veränderungen der laufenden oder geplanten Krebstherapie betroffen. Bei n = 42/121 (34,7 %) der Patienten zeigte sich ein erhöhter psychosozialer Distress (DT ≥ 5). Die häufigste Corona-spezifische Belastung war die Angst vor einer Überlastung des Gesundheitssystems (77,9 %, n = 95/122), gefolgt von der Befürchtung, dass sich Angehörige noch größere Sorgen um die betroffenen Patienten machen (56,2 %, n = 68/121). 71,2 % (n = 74/104) der Patienten sind bereit, sich impfen zu lassen; 60 % (n = 18/30) der zum Zeitpunkt der Untersuchung Unentschlossenen oder Ablehner wünschen sich vor einer endgültigen Entscheidung für die Impfung ein Informationsgespräch mit ihrem Onkologen/ihrer Onkologin. Schlussfolgerung Corona-spezifische Belastungen von Krebspatienten betreffen insbesondere den Verlauf der Therapie, aber auch eine mögliche Überlastung des Gesundheitssystems. Onkologische Behandler-Teams sollten Fragen ihrer Patienten Raum geben, mögliche Unsicherheiten anerkennen, emotionale Unterstützung leisten und auf valide Informationsquellen aufmerksam machen.

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Objective To improve allocation of psychosocial care and to provide patient‐oriented support offers, identification of determinants of elevated distress is needed. So far, there is a lack of evidence investigating the interplay between individual disposition and current clinical and psychosocial determinants of distress in the inpatient setting. Methods In this cross‐sectional study, we investigated 879 inpatients with different cancer sites treated in a German Comprehensive Cancer Center. Assessment of determinants of elevated distress included sociodemographic, clinical and psychosocial characteristics as well as dimensions of personality. Multiple linear regression was applied to identify determinants of psychosocial distress. Results Mean age of the patients was M = 61.9 (SD = 11.8), 48.1% were women. In the multiple linear regression model younger age (β = −0.061, p = 0.033), higher neuroticism (β = 0.178, p = <0.001), having metastases (β = 0.091, p = 0.002), being in a worse physical condition (β = 0.380, p = <0.001), depressive symptoms (β = 0.270, p = <0.001), not feeling well informed about psychological support (β = 0.054, p = 0.046) and previous uptake of psychological treatment (β = 0.067, p = 0.020) showed significant associations with higher psychosocial distress. The adjusted R2 of the overall model was 0.464. Conclusion Controlling for sociodemographic characteristics and dispositional vulnerability, that is neuroticism, current clinical and psychosocial characteristics were still associated with hospitalized patients' psychosocial distress. Psycho‐oncologists should address both, the more transient emotional responses, such as depressive symptoms, as well as more enduring patient characteristics, like neuroticism.

Zusammenfassung Hintergrund Diese Studie untersucht aktuelle Bedürfnisse und Belastungen von ambulanten Krebspatienten im Rahmen der COVID-19-Pandemie. Material und Methoden Zwischen 11/2020 und 02/2021 wurden 122 ambulante Krebspatientinnen und -patienten des Comprehensive Cancer Center München in die Studie eingeschlossen und anhand eines standardisierten, halbstrukturierten Interviews zu Wissensstand und Informationsbedürfnissen in Bezug auf COVID-19, Risikowahrnehmung und Sorgen hinsichtlich der ambulanten Krebsbehandlung, COVID-19-spezifischen Belastungen sowie zum Vertrauen in das Gesundheitssystem und der Impfbereitschaft befragt. Zusätzlich wurde psychosozialer Distress anhand des Distress-Thermometers (DT) erhoben. Ergebnisse Über ein Drittel der Krebspatienten (34,2 %, n = 41/120) hatte noch Informationsbedarf hinsichtlich der Auswirkungen des Coronavirus auf ihre Erkrankung oder Behandlung. 17,2 % (n = 21/122) waren von Veränderungen der laufenden oder geplanten Krebstherapie betroffen. Bei n = 42/121 (34,7 %) der Patienten zeigte sich ein erhöhter psychosozialer Distress (DT ≥ 5). Die häufigste Corona-spezifische Belastung war die Angst vor einer Überlastung des Gesundheitssystems (77,9 %, n = 95/122), gefolgt von der Befürchtung, dass sich Angehörige noch größere Sorgen um die betroffenen Patienten machen (56,2 %, n = 68/121). 71,2 % (n = 74/104) der Patienten sind bereit, sich impfen zu lassen; 60 % (n = 18/30) der zum Zeitpunkt der Untersuchung Unentschlossenen oder Ablehner wünschen sich vor einer endgültigen Entscheidung für die Impfung ein Informationsgespräch mit ihrem Onkologen/ihrer Onkologin. Schlussfolgerung Corona-spezifische Belastungen von Krebspatienten betreffen insbesondere den Verlauf der Therapie, aber auch eine mögliche Überlastung des Gesundheitssystems. Onkologische Behandler-Teams sollten Fragen ihrer Patienten Raum geben, mögliche Unsicherheiten anerkennen, emotionale Unterstützung leisten und auf valide Informationsquellen aufmerksam machen.

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