COVID-19 vaccination hesitancy among southern rural veterans with cancer in the arkansas-louisiana-texas (ArkLATX) region

Abstract

Context: The COVID-19 pandemic continues to be a major socioeconomic disruptor in the U.S. and around the globe. The only intervention that has a far-reaching impact is the adoption of an efficient large-scale vaccination campaign with the highly effective COVID-19 vaccines. While the success of this strategy is predicated on the presence of adequate healthcare systems capacity, it also hinges on the trust and acceptance of the public. Vaccine hesitancy, which varies by the geosocial context, is considered a top obstacle. Objective: The Overton Brooks VA embarked on a survey to explore the demographic patterns and reasons for COVID-19 vaccination hesitancy among cancer patients. Study Design: phone survey. Setting: five Hematology-Oncology clinics across the ArkLATX. Population: random sample of 240 veterans with cancer. Intervention: Veterans were asked whether they are interested in getting vaccinated and to state the reason if they declined. They were asked to categorize the reason as relating to safety, efficacy, inadequate Information, aversion to any vaccine, not wanting to be the first, or other/explain. Outcome Measures: 1. Descriptive statistics of those who want and those who decline the vaccine. 2. Determine the impact of demographic factors on COVID19 vaccine hesitancy. Results: The median age was 71 years. The participants were 92% males and 40% Black vs 59% White. Seventy nine percent wanted to get vaccinated. Among the veterans that declined (21%), the reasons were due to concerns about safety (33%), not wanting to be the first (33%), anti-vaxxer stance (14%), and inadequate information (8%). No one cited concerns about efficacy as a reason. Other reasons (12%) included seeing no reason for the vaccination, citing severe reactions to prior vaccines, and voicing mistrust of the government. There were no statistical differences between veterans that approved or declined the vaccine with respect to demographic characteristics. Conclusions: This survey indicates that the majority of ArkLATX veterans with cancer are willing to be vaccinated against COVID-19. The major reasons behind vaccine hesitancy seem to be information problems consisting of questions about safety, inadequate information, and seeing no reason for the vaccine. Such barriers can be potentially circumvented by providing the appropriate information and counseling.

Insights into the Impact of Hesitancy on Cancer Care and COVID-19

“…Mistrust of the health-care system, the misconception that COVID-19 vaccination is contraindicated in patients with breast cancer, not having a close acquaintance already vaccinated against COVID-19, noncompliance with prior influenza immunization, being aged younger than 60 years, having low educational attainment and not having a close acquaintance deceased due COVID-19 were all causes of the refusal of COVID-19 vaccines [ 42 ]. No study cited concerns about efficacy as a reason for refusal of the vaccine [ 43 ] ( Table 1 ).…”

Prevalence and Assessment of Factors Associated with COVID-19 Vaccine Hesitancy in an Ethnic Minority Oncology Patient Population

“…In a cross-sectional study using online surveys of US cancer patients in December 2020, respondents who were unlikely/unsure of accepting the COVID-19 vaccine were more often Black compared to Non-Black and 55% less likely to accept a COVID-19 vaccine [ 33 ]. Major reasons behind hesitancy were questions of safety, inadequate information, mistrust of the government, seeing no reason for the vaccine, and fear of side effects [ 33 , 34 , 35 ]. The strongest predictors of vaccine uptake were plans to encourage vaccination of family, friends, community, and physician recommendation.…”