Influence of provider recommendations to restart vaccines after childhood cancer on caregiver intention to vaccinate

Abstract

Purpose: We studied the influence of oncology and primary care provider (PCP) recommendations on caregiver intentions to restart vaccines (e.g., catch-up or boosters) after cancer treatment. Methods: We surveyed primary caregivers ages 18 or older with a child who had completed cancer treatment 3–36 months prior (N=145) about demographics, child’s vaccination status, and healthcare factors (e.g., provider recommendations, barriers, preferences for vaccination). We compared these factors by caregiver’s intention to restart vaccines (“vaccine intention” vs. “no intent to vaccinate”) using bivariate and multivariable analyses. Results: Caregivers were primarily ages 30–39 years (54.9%), mothers (80.6%), college graduates (44.4%), Non-Hispanic (89.2%), and married (88.2%). Overall, 34.5% of caregivers did not know which vaccines their child needed. However, 65.5% of caregivers reported vaccine intention. Fewer caregivers with no intention to vaccinate believed vaccinating their child helps protect others (85.4% vs. 99.0%, p<0.01), that vaccines are needed when diseases are rare (83.7% vs. 100.0%, p<0.01), and that vaccines are safe (80.4% vs. 92.6%, p=0.03) and effective (91.5% vs. 98.9%, p=0.04) compared to vaccine intention caregivers, respectively. Provider recommendations increased caregivers’ likelihood of vaccine intention (oncologist: RR=1.65, 95% CI 1.27–2.12, p<0.01; PCP: RR=1.51, 95% CI 1.19–1.94, p<0.01). Conclusions: Provider recommendations positively influence caregivers’ intention to restart vaccines after childhood cancer. Guidelines are needed to support providers in making tailored vaccine recommendations. Implications for Cancer Survivors: Timely vaccination after childhood cancer protects patients against vaccine-preventable diseases during survivorship. Caregivers may benefit from discussing restarting vaccinations after cancer with healthcare providers.

Using Behavioral Science to Address COVID-19 Vaccine Hesitancy Among Cancer Survivors: Communication Strategies and Research Opportunities

“…As health providers remain the most trusted source of information on vaccination for most patients (Dubé et al, 2013 ), they have an important role to play in addressing vaccine hesitancy (Potter et al, 2021 ). Prior research has not only demonstrated the importance of a provider recommendation on vaccine uptake – including among cancer patients (Kasting et al, 2019 ; Klosky et al, 2015 ; Lu et al, 2018 ; Warner et al, 2020 ), but has also shown that recommendation strength is an important factor in vaccination outcomes (Gilkey et al, 2016 ; Rosenthal et al, 2011 ). Improving the trustworthiness, quality, and consistency of provider communication regarding vaccines could therefore be an important strategy for building trust and addressing COVID-19 vaccine hesitancy among cancer survivors.…”

Vaccination coverage among paediatric onco-haematological patients: an Italian cross-sectional study

“…However, guidelines are needed to allow vaccine providers to formulate tailored recommendations. 20 In our sample, older age at enrollment increased the risk of missing vaccination. This may have been due to an earlier lack of knowledge among physicians about the risk/benefit ratio of vaccination for onco-hematological patients.…”

Human papillomavirus vaccination uptake among childhood cancer survivors in Western New York

“…This may be of concern as cancer treatments that elevate the risks for immunological health consequences, 37 like graftversus-host disease (GvHD) [38][39][40] or prolonged immunodeficiency from immunosuppressant drugs, 41,42 can increase susceptibility to viral infections such as HPV and to related secondary cancers. 32,[43][44][45][46][47] Although Landier et al ( 2022) recently detected a similar antibody response from the HPV vaccine in cancer survivors after treatment compared to the general population, 48 inconsistent vaccination guidelines and recommendations for cancer survivors [49][50][51] may still impact HPV vaccine uptake. For instance, initiation of adolescent vaccines normally occurs 6 months after completing cancer treatment, 10,11,52 but standardized clinical guidelines for HPV vaccine initiation or resumption after cancer treatment are unclear.…”

“…Although Landier et al. (2022) recently detected a similar antibody response from the HPV vaccine in cancer survivors after treatment compared to the general population, 48 inconsistent vaccination guidelines and recommendations for cancer survivors 49–51 may still impact HPV vaccine uptake. For instance, initiation of adolescent vaccines normally occurs 6 months after completing cancer treatment, 10,11,52 but standardized clinical guidelines for HPV vaccine initiation or resumption after cancer treatment are unclear 12 .…”