Misconception contributed to COVID-19 vaccine hesitancy in patients with lung cancer or ground-glass opacity: a cross-sectional study of 324 Chinese patients

Abstract

Patients highly vulnerable for COVID-19 infection have been proposed to take priority for vaccination. However, vaccine hesitancy is usually more prevalent in these patients. Investigation around modifiable contributors of vaccine hesitancy plays a pivotal role in the formulation of coping strategies. We aimed to evaluate the impact of vaccine misconception in patients with lung cancer or pulmonary ground-glass opacity (GGO). A web-based questionnaire was constructed based on a qualitative interview with 15 patients and reviewed by a multidisciplinary expert panel. Six Likert five-scale questions were used to generate a score of vaccine misconception (SoVM), which ranged from 0 to 24 points, with a higher score indicating a higher level of misconception. A total of 61.6% (324/526) patients responded to our questionnaire. A higher proportion of low willingness patients (n = 173), compared to high willingness patients (n = 151), disagreed that cancer patients should be prioritized for COVID-19 vaccination (82.1% vs. 50.3%, p < .001) and perceived themselves to have contraindications (45.7% vs. 15.9%, p < .001). The mean SoVM was significantly lower in the high willingness group than the low willingness group (9.9 vs. 13.0, p < .001). Among the unvaccinated patients, the SoVM increased as the willingness to be vaccinated decreased ( p < .0001). In multivariable logistic regression, patients with higher SoVM (OR 0.783, 95% CI 0.722–0.848), being female (OR 0.531, 95% CI 0.307–0.918) or diagnosed with lung cancer (OR 0.481, 95% CI 0.284–0.814) were independently associated with a lower willingness to be vaccinated against COVID-19. Receiver operating characteristic curve suggested that a SoVM of 11 yielded the best discrimination for predicting the willingness to receive COVID-19 vaccine (AUC = 0.724). The study findings reveal that patient misconception significantly contributes to vaccine hesitancy and needs to be addressed by evidence-based education tailored to their specific concerns.

Facilitators and barriers to COVID-19 vaccine uptake among women in two regions of Ghana: A qualitative study

“…Instead of advocating for vaccine uptake, these religious leaders provided spiritual guidance to their congregations to help protect them from COVID-19. Such guidelines and misconceptions about COVID-vaccine negatively affect its uptake [ 57 – 59 ]. We recommend that further studies should employ quantitative approaches to examine the prevalence of the misconceptions identified in this study and how these are likely to influence vaccination generally.…”

The intention to get COVID-19 vaccine and vaccine uptake among cancer patients: An extension of the theory of planned behaviour (TPB)

“…The Italian government has launched a national vaccination campaign against COVID-19, yet some people still refuse to be vaccinated, including cancer patients. The most common reasons for vaccine hesitancy documented in cancer patients are fear of the vaccine impact on cancer therapy or outcome [20], fear of side effects or vaccine safety [20][21][22], and lack of information or misconception [16,23].…”

“…Furthermore, data demonstrated high rates of hesitancy about the COVID-19 vaccine [16,17], which jeopardised immunisation efforts [18,19], and these problems have not fully abated. In addition, preliminary studies identified this high rate of COVID-19 vaccine hesitancy even in cancer patients [20][21][22][23] and survivors [24]. Therefore, it is crucial to understand which factors can predict individuals' intention to accept COVID-19 vaccinations, particularly for more vulnerable groups such as cancer patients.…”

Changes in Behavior After Vaccination and Opinions Toward Mask Wearing: Thoracic Oncology Patient–Reported Experiences During the COVID-19 Pandemic

“…Compared with vaccination rates in cancer patients and their reported willingness to be vaccinated in other studies, our patients with a thoracic malignancy demonstrated a high acceptance of the COVID-19 vaccination. 25,26 Surveys of Polish, Chinese, and Korean cancer patients showed a willingness to be vaccinated of 60.3%, 26 46.6%, 25 and 61.8%, 27 respectively. Reasons for the high vaccination rate in our study group may, on one hand, be related to the high risk of severe complications from a SARS-CoV-2 infection in patients with a thoracic malignancy and the immunosuppression during therapy.…”