Willingness to receive the second booster of COVID-19 vaccine among older adults with cancer: a stratified analysis in four provinces of China

Abstract

BackgroundDespite the elevated COVID-19 risk for older adults with cancer, vaccine hesitancy poses a significant barrier to their immunization. Intriguingly, there is limited research on the prevalence of willingness to receive the second booster dose and associated determinants in older adults with cancer.ObjectiveOur objective was to ascertain the level of awareness about COVID-19 vaccines and to uncover the factors influencing the willingness to receive the second booster among Chinese cancer patients aged 65 years and over.MethodsTo achieve our objective, we conducted a multicenter cross-sectional study in four tertiary hospitals from four provinces of China. This involved using a Health Belief Model (HBM) based self-administered questionnaire and medical records. Subsequently, we employed multivariable logistic regression to identify factors influencing the second COVID-19 booster vaccine willingness.ResultsOur results showed that among 893 eligible participants, 279 (31.24%) were aged 65 years and over, and 614 (68.76%) were younger. Interestingly, the willingness to receive the second COVID-19 booster vaccine was 34.1% (95/279) (OR: 1.043, 95% CI: 0.858, 1.267) in participants aged 65 years and over, which was similar to participants aged under 65 years (34.1% vs. 35.5%, p = 0.673). Furthermore, our findings revealed that a positive attitude toward the booster and recommendations from healthcare providers and family members were positively associated with vaccine willingness. Conversely, perceptions of negative impacts on cancer control and vaccine accessibility regarding the second COVID-19 booster were inversely related to the outcome event (all p < 0.05).ConclusionOur study concludes with the finding of a low willingness toward the second COVID-19 booster in Chinese cancer patients, particularly in the older adults, a fact which warrants attention. This reluctance raises their risk of infection and potential for severe outcomes. Consequently, we recommend using media and community outreach to dispel misconceptions, promote the booster’s benefits, and encourage vaccine discussions with healthcare providers and family members.

Behavior Change Theories and Models Within Health Belief Model Research: A Five-Decade Holistic Bibliometric Analysis

“…The theme of COVID-19 has gained prominence as researchers seek to understand and promote desirable health behaviors related to preventive measures, vaccination, and adherence to public health guidelines. Within the context of the HBM, constructs such as perceived susceptibility and severity of the disease, cues to action (such as public health messaging), and perceived benefits and barriers to preventive behaviors provide a valuable framework for understanding and guiding behavior change efforts during the pandemic [2,8,19,27,36,37].…”

“…Vaccine hesitancy is a trending topic (Figure 5) in HBM research, as a growing number of individuals perceive vaccines as unsafe and unnecessary, leading to decreased vaccine confidence and coverage. Applying HBM, researchers are examining how factors such as perceived susceptibility, severity, benefits, barriers, and cues to action shape vaccine-related beliefs and behaviors [2,8,27,44,45]. This research aims to identify key determinants of vaccine hesitancy to inform targeted interventions and communication strategies, as maintaining high vaccination rates is crucial for population health and preventing the resurgence of vaccine-preventable diseases [2,45].…”

“…The model posits that an individual's likelihood of engaging in a health-promoting behavior is determined by their perceived susceptibility to a health threat, perceived severity of the health threat, perceived benefits of taking action, and perceived barriers to taking action. In the context of health promotion and health education, HBM can be a valuable tool for designing and implementing effective interventions [8][9][10].…”