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

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Journal of Cancer Survivorship Aims and scope Submit manuscript

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 that 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 with 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.

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Abbreviations

CI:

Confidence interval

COG:

Children’s Oncology Group

IDSA:

Infectious Disease Society of America

HPV:

Human papillomavirus

PCH:

Primary Children’s Hospital

PCP:

Primary care provider

RR:

Relative risk

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Acknowledgments

We thank Akanksha Acharya for her assistance with study design, the Academic Associate’s Program at Primary Children’s Hospital who assisted with participant recruitment, and the generous caregivers who gave of their time to participate in this study.

Funding

The authors would like to acknowledge funding from the American Cancer Society Institutional Research Grant (PI: Don Ayer) as well as funding from the Huntsman Cancer Institute/Huntsman Cancer Foundation. Additional support was provided by P30CA042014 from the National Cancer Institute (PI: Mary Beckerle). Dr. Warner also received support from the National Cancer Institute of the National Institutes of Health under Award Numbers F31CA221000 and T32CA078447.

Author information

Authors and Affiliations

  1. University of Arizona Cancer Center, 3838 N Campbell Ave, Tucson, AZ, 85719, USA

    Echo L. Warner

  2. Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, Utah, 84112, USA

    Echo L. Warner, Perla L. Vaca Lopez, Deanna Kepka, Karely Mann, Heydon K. Kaddas, Samantha T. Pannier & Anne C. Kirchhoff

  3. College of Nursing, University of Utah, 10 S 2000 E, Salt Lake City, UT, 84112, USA

    Echo L. Warner, Deanna Kepka & Anne C. Kirchhoff

  4. Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA

    Douglas Fair, Mark Fluchel & Anne C. Kirchhoff

  5. Primary Children’s Hospital, Intermountain Healthcare, 100 Mario Capecchi Dr, Salt Lake City, UT, 84113, USA

    Douglas Fair & Mark Fluchel

  6. Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA

    Elizabeth D. Knackstedt

  7. Utah AIDS Education and Training Center, School of Medicine, University of Utah, 30 N 1990 E, Salt Lake City, UT, 84132, USA

    Laura Martel

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  1. Echo L. Warner
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Corresponding author

Correspondence to Echo L. Warner.

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The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Abstract name: Caregiver intention to restart vaccinations after childhood cancer treatment. Meeting name & date: 43rd annual meeting of the American Society of Preventive Oncology in March 2019 Publication website: https://cebp.aacrjournals.org/content/28/3/622.2.abstract

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Warner, E.L., Vaca Lopez, P.L., Kepka, D. et al. Influence of provider recommendations to restart vaccines after childhood cancer on caregiver intention to vaccinate. J Cancer Surviv 14, 757–767 (2020). https://doi.org/10.1007/s11764-020-00890-y

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