Incidence and risk factors of vaccination hesitancy among early-stage lung cancer patients: a cross-sectional study.
Zhang Fangyuan F, Liu Lifeng L, Zhao Jing J
Patients with lung cancer are highly prevalent and vulnerable to coronavirus disease 2019 (COVID-19), and vaccination is believed to be the most effective weapon to control this epidemic. Besides, COVID-19 vaccination is always withheld among patients with advanced lung cancer receiving therapy. Thus, this study aims to explore the prevalence of COVID-19 vaccination hesitancy and identify its associated factors in patients with early-stage lung cancer. A cross-sectional study of 728 patients with early-stage lung cancer before surgery was conducted to assess their level of knowledge, attitudes and hesitancy toward COVID-19 vaccination at Tianjin Medical University Cancer Hospital and Institute, from May to November 2023 in China. Multivariate logistic regression analysis was used to identify the factors influencing the likelihood of receiving a COVID-19 vaccination among early-stage lung cancer patients. A total of 151 (20.7%) preoperative lung cancer patients with early stage reported concerns about the acceptance of COVID-19 vaccines. Multivariate logistic regression analysis revealed that admitted patients with early-stage lung cancer before surgery who thought the vaccine was not safe (vs. yes) [odds ratio (OR) =5.305, 95% confidence interval (CI): 1.964-14.327; P=0.001], who would not recommend their family members or friends to get vaccinated (vs. yes) (OR =2.511, 95% CI: 1.287-4.901; P=0.007), and who would not like to pay for the vaccine (vs. yes) (OR =3.841, 95% CI: 2.091-7.054; P<0.001) were more likely to refuse to get vaccinated. Conversely, participants who had no concerns about the vaccine exacerbating their cancer prognosis (vs. yes) (OR =0.203, 95% CI: 0.071-0.577; P=0.003) were more likely to be open to vaccination. In addition, the top two concerns related to COVID-19 vaccine acceptance were immediate serious adverse effects (48.3%) and long-term adverse effects after COVID-19 vaccination (87.4%). This study provides preliminary estimates of the rate of COVID-19 vaccination hesitancy among preoperative patients with early-stage lung cancer. The safety of COVID-19 vaccines remains a key determinant of vaccination acceptance. Research on the safety and efficacy of COVID-19 vaccines among patients with lung cancer is urgently needed to promote a global vaccination campaign.