ABSTRACT
ᴥ SUMMARY. This study aimed at pilot-testing a new screening tool for assessing risk perception of and hesitancy about anti-COVID-19 in patients diagnosed with cancer. We recruited consecutive cancer patients (n = 356) who were either in treatment or follow-up. All the participants completed several measures of risk perception, confidence in safeguards, treatment adherence, and psychosocial distress. Scree plot and parallel analysis suggest a unifactorial structure (explained variance = 47.816%). The total scale was found a reliable 7-item measure (Cronbach’s a = .806;McDonald’s Ω= .810). Correlations and comparisons to other measures confirmed concurrent and predictive validity. The new measure reports a moderate correlation (r = .410;p<.001) with treatment non-adherence, whereas the correlation with distress was not significant. In conclusion, the new measure seems to be a reliable and valid tool for assessing risk anti-COVID-19 vaccine hesitancy in patients diagnosed with cancer. Further research is needed to confirm the unifactorial structure or better understand the underlying psychological mechanisms of vaccine hesitancy. © 2021, Giunti Psychometrics. All rights reserved.
ABSTRACT
Background: Healthcare authorities at National and Regional level have prioritized vaccinations for cancer patients. Patients with cancer are among the very high-risk groups for adverse outcomes including hospitalization and/or death from COVID-19. The Medical Oncology Unit in Florence encourage vaccination for all patients with cancer being actively treated, regardless of treatment type, performance status, or life expectancy. A COVID-19 vaccination campaign, with the support of the Health Departments, was launched on April 02. The Pfizer BNT162b2 mRNA or the Moderna mRNA-1273 vaccines, based on availability, were used. Data regarding the safety of the mRNA vaccines in patients with cancer were collected. Material (patients) and methods: Between April 02 and May 07, vaccination was offered to patients actively undergoing cancer treatment. Side effects were monitored via detailed telephone questionnaires. Results: 913 patients were offered the vaccine. 22 (2%) refused the vaccination, mostly due to fear of side-effects, 73 (8%) patients did not answer the call, while 181 (20%) patients were had already been vaccinated. 637 patients received the first vaccination dose, of whom 601 (94%) received the second dose. The second dose was omitted if the patient contracted SARS-CoV-2 infection between three and six months before the first dose. The most common side-effects after the first dose were local, with 126 (24%) of 523 evaluable patients reporting pain at the site of injection. Systemic side-effects included fatigue (34 [6%]), headache (18 [3%]), muscle pain (14 [2%]), fever (17 [3%] and chills (3 [1%]). Two of 523 patients were admitted to hospital for acute allergic reactions. Three patients died after the first dose due to disease progression and two patients refused the second dose. More systemic side-effects were observed after the second dose of vaccine. Pain at the injection site was reported in 18 [3%] of the 502 evaluable patient, whereas the most common systemic side effects were muscle pain (39 [34%]), fatigue (19 [34%]), headache (31 [16%]), fever (102 [10%]), chills (17 [10%]). None of the reported side-effects required admission to hospital or any other special intervention. Two patients developed asymptomatic SARS-CoV-2 infection after the first and the second dose of vaccine, respectively. Conclusions: The reassuring safety signal regarding the mRNA COVID-19 vaccines in patients with cancer support call for vaccination of cancer patients.
ABSTRACT
Background: Inadequate knowledge about extent of coronavirus disease 2019 (COVID19) epidemic challenges health response and planning. COVID19 mortality among cancer patients (pts) is higher than in general population. The identification of asymptomatic COVID19 cancer pts is important from both a personal and a health system point of view as immunosuppression increases COVID19 disease severity. Screening for asymptomatic carriers is being tested in some categories. The best method for screening and monitoring is yet unknown. Material and methods: Azienda Usl Toscana Centro Oncology department tested pts receiving chemo-or radio-therapy. Aims were checking the prevalence of asymptomatic COVID19 cancer pts and evaluating the need and the best method for subsequent monitoring. Pts were offered both a quantitative serologic IgM and IgG test (Qt-ST) and a RT-PCR test for SARS-CoV-2 in nasopharyngeal and oropharyngeal swabs (NOS). As the Qt-ST is costly and requires hours for response, in S.M. Annunziata Hospital (SMA), pts were also tested with a qualitative serologic IgM and IgG method (Ql-ST) to collect information on different serologic assays. Results: Between May 11th and 17th, 1148 pts receiving an active antineoplastic treatment signed a written informed consent and were screened with RT-PCR for SARS-CoV-2 in NOS and Qt-ST. 317 pts in SMA were also tested with Ql-ST. 16 pts refused RT-PCR, 3 Qt-ST and none Ql-ST. 89 pts with haematological malignancy didn't receive ST. Only 0.44% (5/1132) of asymptomatic cancer pts had a positive RT-PCR. 1 of them had COVID19 disease and was declared healed 14 days before screening. All pts with a positive RT-PCR in NOS had a positive Qt-ST for IgM. 1/5 had also IgG positivity. Qt-ST was positive in 26/1145 pts (2.3%): 3 were IgM+/ IgG+, 10 IgM+/IgG-and 13 IgM-/IgG+. 19.2% of pts with a positive Qt-ST (5/26) were asymptomatic carriers of COVID19 disease. In SMA, 6/317 (1.9%) had a positive Qt-ST, 21 (6.6%) a positive Ql-ST and all were negative for RT-PCR in NOS. Conclusions: With a positivity of 0.44%, RT-PCR for SARS-CoV-2 in NOS may not be cost-effective for screening in asymptomatic cancer pts under antineoplastic treatment from a patient point of view. However, RT-PCR may improve both the compliance and the safety's sense of pts and operators in hospital and is mandatory in case of ST positivity. Qt-ST is more accurate than Ql-ST. Both Qt-ST and Ql-ST were safe and may be a proper option for monitoring cancer pts based on local organization.