Vaccine hesitancy in cancer patients: A rapid review.

INTRODUCTION: Vaccination is a key strategy to limit the impact of the COVID-19 pandemic, among vulnerable groups such as cancer patients. However, COVID-19 vaccine hesitancy is limiting vaccination uptake in this population as in others. This study aimed to synthesise the emerging literature on vaccine hesitancy in this population and in Oncology health professionals, reasons for and factors associated with hesitancy, and interventions that address hesitancy. METHODS: A rapid review was undertaken PubMed, Ovid and Google across all years up to October 2021 for articles in English, from any country or region, addressing the above issues. Individual case studies, opinion pieces, commentary articles and conference abstracts were excluded. Article screening, data extraction and bias assessment were conducted by two authors. A narrative synthesis of the data was undertaken. RESULTS: Eighteen eligible articles were identified. Reported COVID-19 vaccine hesitancy rates varied from 76.7 % to 3.9 %, with a mean of 38.4 %. A large international study (n > 20,000) reported a more conservative hesitancy rate of 19 %. Six broad, common reasons for hesitancy were identified. Oncologist advice was valued by patients. DISCUSSION: Vaccine hesitancy remains a significant concern in the oncology context. Oncologists are key to addressing hesitancy and providing tailored advice to cancer patients. PRACTICE IMPLICATIONS: Where possible, patients appreciate personalised, tailored information about vaccination which addresses its interaction with cancer and its treatment. Education programmes for oncologists to support effective communication in this context are needed. Webinars and peer-to-peer counselling may be useful but remain to be proven.

Development of Psycho-Oncology telehealth recommendations

Aims: The COVID-19 pandemic triggered rapid implementation of telephone and videoconference telehealth across Australia. The Psycho-Oncology Cooperative Research Group (PoCoG) investigated the barriers and enablers to wider implementation post pandemic. Psychologists working in oncology face unique challenges such as working with patients experiencing existential issues and report inadequate training in conducting telehealth psychology. This research aimed to address the paucity of evidence available to guide adaption of therapy to telehealth through the development of evidence-based consensus recommendations for Psycho-oncology . Methods : Content for the recommendations was developed based on a review of the psychology and Psycho-Oncology literature and stakeholder feedback through an expert advisory group (n = 14) comprising clinical psychology, Psycho-Oncology and health communication/education experts, guiding the focus of the content. The compilation of recommendations involved an iterative co-design process. Clinical scenarios, self-reflection exercises and clinical guidance were incorporated to facilitate clinical relevance. The relative importance of content topics was assessed based on a Delphi consensus process that is ongoing. Results : The co-design approach identified key recommendations;(1) adaptations to therapeutic techniques, (2) clinical/practical strategies (including worksheets and case studies), (3) communication challenges, (4) maintaining the therapeutic alliance, and (5) managing patient presentations. A national Delphi consensus process involving clinical psychologists working in oncology is ongoing and will guide further refinement of the educational resource. Conclusions : These recommendations fill an identified gap in the literature and provide a robust expert-endorsed document to guide clinicians through telehealth in the Psycho-Oncology field. This will support an increase in sustainability of, and confidence in, Psycho-Oncology telehealth moving forward.