Abstract
Purpose
To understand the drivers and barriers for COVID-19 vaccination in people with cancer in Australia.
Methods
A cross-sectional, online survey, distributed nationally following the establishment of community vaccination programs, wider availability of COVID-19 vaccines and emergence of new variants. Consisting of 21 questions, the survey was designed to determine the behavioural and social drivers of vaccination, participant demographics, underlying disease and treatment, and vaccination status. It was open from the 10th of August 2021 to the 7th of September 2021, recruiting people who had a previous history of cancer (diagnosed or treated in the past 5 years).
Results
A total of 1506 responses were included in the final analysis. Overall, 87.8% reported a positive attitude toward vaccination and 83.1% had received at least one dose of a COVID-19 vaccine. Perceived risk of COVID-19 infection (for self and others) and engagement with a trusted health professional were key drivers for vaccination, while concerns about vaccine development, safety and side effects were barriers. Concerns about vaccination mostly stemmed from a place of misinformation, rather than a broader disregard of vaccines. Just over a third (497, 34.3%) of the respondents were concerned that the vaccine would impact their cancer treatment.
Conclusion
Overall, participants had positive attitudes toward COVID-19 vaccination and thought it was safe. Findings supported the role of health professionals and cancer organisations as trusted information providers and calls for more, credible information to help people with cancer make informed decisions about the COVID-19 vaccine.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
The data that support the findings of this study are not openly available due to reasons of sensitivity, but questions or requests may be made to the corresponding author for consideration in line with the ethics approval and policies that govern the study.
References
World Health Organization (2023). WHO coronavirus (COVID-19) dashboard. covid19.who.int. Accessed 27 February 2023
Liang W et al (2020) Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol 21(3):335–337. https://doi.org/10.1016/S1470-2045(20)30096-6
Chavez-MacGregor M et al (2021) Evaluation of COVID-19 mortality and adverse outcomes in US patients with or without cancer. JAMA Oncol 8(1):69–78. https://doi.org/10.1001/jamaoncol.2021.5148
Corey L et al (2021) SARS-CoV-2 variants in patients with immunosuppression. N Engl J Med 385(6):562–566. https://doi.org/10.1056/NEJMsb2104756
Australian Government Deparment of Health (2021). COVID-19 vaccine national roll-out strategy. https://www.health.gov.au/sites/default/files/documents/2021/01/covid-19-vaccination-australia-s-covid-19-vaccine-national-roll-out-strategy.pdf. Accessed May 2022.
Australian Institute of Health and Welfare (2021). The first year of COVID-19 in Australia: direct and indirect health effects. https://www.aihw.gov.au/getmedia/a69ee08a-857f-412b-b617-a29acb66a475/aihw-phe-287.pdf.aspx?inline=true. Accessed May 2022
Danchin M, Buttery J (2021) COVID-19 vaccine hesitancy: a unique set of challenges. Intern Med J 51(12):1987–1989. https://doi.org/10.1111/imj.15599
Barriere J et al (2021) Acceptance of SARS-CoV-2 vaccination among French patients with cancer: a cross-sectional survey. Ann Oncol 32(5):673–674. https://doi.org/10.1016/j.annonc.2021.01.066
Brodziak A et al (2021) Attitudes of patients with cancer towards vaccinations-results of online survey with special focus on the vaccination against COVID-19. Vaccines (Basel) 9(5):411. https://doi.org/10.3390/vaccines9050411
Di Noia V et al (2021) The first report on coronavirus disease 2019 (COVID-19) vaccine refusal by patients with solid cancer in Italy: early data from a single-institute survey. Eur J Cancer 153:260–264. https://doi.org/10.1016/j.ejca.2021.05.006
Australian Technical Advisory Group (2023). ATAGI 2023 booster advice. https://www.health.gov.au/news/atagi-2023-booster-advice. Accessed Mar 2023
Harris PA et al (2019) The REDCap consortium: building an international community of software platform partners. Journal of biomedical informatics 95:103208. https://doi.org/10.1016/j.jbi.2019.103208
World Health Organization & United Nations Children's Fund (UNICEF) (2021). Data for action: achieving high uptake of COVID-19 vaccines: gathering and using data on the behavioural and social drivers of vaccination: a guidebook for immunization programmes and implementing partners: interim guidance. https://apps.who.int/iris/handle/10665/339452. Accessed May 2022.
Thorne S (2016) Interpretive description: qualitative research for applied practice. Routledge, New York
Australian Government Department of Health (2021). COVID-19 vaccine roll-out. https://www.health.gov.au/sites/default/files/documents/2021/09/covid-19-vaccine-rollout-update-7-september-2021.pdf. Accessed May 2022.
Day D et al (2022) Serious underlying medical conditions and COVID-19 vaccine hesitancy: a large cross-sectional analysis from Australia. Vaccines 10(6):851. https://doi.org/10.3390/vaccines10060851
Nguyen M et al (2022) COVID-19 vaccination rates, intent, and hesitancy in patients with solid organ and blood cancers: a multicenter study. Asia-Pac J Clin Oncol 18(6):570–577. https://doi.org/10.1111/ajco.13754
Heath K et al (2022) Intent to be vaccinated against COVID-19 in Victoria, Australia. Vaccines 10(2):209. https://doi.org/10.3390/vaccines10020209
Dizon DS et al (2021) People with cancer are likely to accept the COVID-19 vaccine, but politics tracks with attitudes: an inspire and COSMO survey. J Clin Oncol 39(15_suppl):1531. https://doi.org/10.1200/JCO.2021.39.15_suppl.1531
Brodziak A et al (2021) Attitudes of patients with cancer towards vaccinations—results of online survey with special focus on the vaccination against COVID-19. Vaccines 9(5):411. https://doi.org/10.3390/vaccines9050411
Acknowledgements
The authors would like to acknowledge the representatives from Cancer Council Victoria’s Community Advisory Network and Peter MacCallum Cancer Centre’s Consumer Register for supporting survey development and design. Additionally, we would like to thank the individuals and organisations involved in the study recruitment, including Breast Cancer Network of Australia’s Review and Survey Group.
Funding
This project was undertaken as a collaboration between Cancer Council Victoria and Peter MacCallum Cancer Centre’s National Centre for Infections in Cancer.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Amelia Hyatt, Christie Allan, Amanda Appathurai, Benjamin W Teh and Megan Crane. The first draft of the manuscript was written by Christie Allan, Amelia Hyatt and Benjamin W Teh, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Ethics approval
The project was reviewed and approved by Cancer Council Victoria’s human research ethics committee, (ethics number IER 2103). It was carried out in accordance with the National Statement on Ethical Conduct in Human Research 2007 and the Australian Code for Responsible Conduct of Research 2007.
Competing interests
Benjamin W Teh has been on the advisory board for Moderna, CSL-Behring and Takeda, received research funding from Seqirus, Sanofi, Merck Sharp and Dohme and honoraria (to institution) from Pfizer, Alexion, Gilead and Janssen. Christie Allan, Amanda Piper, and Danielle Spence acknowledge their employer, Cancer Council Victoria, provides cancer information and support — an activity reported in this project. The other authors have no relevant financial or nonfinancial interests to disclose for this study.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary information
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Allan, C., Hyatt, A., Appathurai, A. et al. Drivers and barriers to COVID-19 vaccination in Australians with cancer. Support Care Cancer 31, 479 (2023). https://doi.org/10.1007/s00520-023-07942-w
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s00520-023-07942-w