ABSTRACT
Aims: Vaccination uptake is the principal focus of the world-wide response to the COVID-19 pandemic. Vaccine hesitancy remains a critical issue. Our aim was to ascertain rates and reasons for vaccine hesitancy in people with breast cancer (BC) in Australia. Method(s): Between June and October 2021, an anonymous online survey was conducted among people with solid organ cancer treated at nine Australian treatment centres. Data collected included demographics and clinical characteristics. Vaccine hesitancy and related beliefs were assessed using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale (OCVCCS), and the Disease Influenced Vaccine Acceptance Scale-Six. Descriptive statistics, chi-squared and linear regression were used. Results for the BC subgroup are reported. Result(s): The BC subgroup (N = 986, mean age 58.4 years, 99% female) comprised 36.6% of the responses in the solid cancer population (N = 2691). Most (76%) were treated at metropolitan centres and 64% were receiving ongoing treatment. Early BC was more commonly reported than metastatic BC (77% vs. 23%). Overall, 82% self-reported at least one COVID-19 vaccine dose. Unvaccinated participants were more likely to diagnosed with BC for a shorter time (<2 years (22.1%) vs >=2 years (14.5%), p = 0.003). Participants with metastatic BC were more likely to be unvaccinated and report greater disease-related vaccine concerns and hesitancy, when compared with participants with early BC (all p < 0.05). When compared with participants with all other solid cancers, participants with BC reported more negative attitudes towards COVID-19 vaccine side-effects (OCVCCS Side-Effects subscale mean scores: 5.19 (SD 1.91) vs. 5.46 (SD 1.82), p < 0.001). Conclusion(s):Despite a relatively high rate of self-reported vaccination, people with BC reported lower vaccine confidence when compared with all other solid cancers. A better understanding of these inequalities, and strategies to address vaccine confidence in people with BC, particularly those with metastatic BC, should be developed.
ABSTRACT
Aim: Peoplewith cancer living in regional Victoria are less likely to participate in a clinical trial than metropolitan patients.We established a new geographically based trials network with the gaol of increasing the number of regional cancer patients recruited to clinical trials. Method(s): Initially six regional services and Cancer Trials Australia (CTA) collaborated to form Regional Trials Network Victoria (RTNV). Two more sites, Latrobe Regional Hospital and Mildura Public Hospital were added in 2021. This network represents a population of 1.9 million people and approximately 8000 new cancer diagnoses each year. Access to cancer clinical trials at regional sites was achieved by: Building capacity of regional clinical trial units Improving the efficiency of clinical trial conduct Implementing the COSA teletrial framework Investing in the capability of staff Increasing the number of clinical trials Results: In 2017, the CCV Clinical Trial Management Scheme (CTMS) recorded 1587 Victorians recruited to cancer clinical intervention trials. 428 resided in regional Victoria, but only 81 of these participated at a regional site, with others needing to travel. In 2017, 135 patients were recruited to RTN sites (regional plus Geelong) across 55 trials. By 2021, despite the impacts of the COVID19 pandemic the number of recruiting clinical trials increased by 54% and the number of regional patients recruited to CTMS studies in the network increased to 179. Driven by uptake of teletrials and registry trials total recruitment increased to 620 patients. RTNV leveraged funding to sustain core activity and was awarded $18.5 million from the Medical Research Future Fund to conduct health services research over the next 5 years. Conclusion(s): The RTNV is a successful implementation of a regionally based clinical trials network, improving access and participation of regional patients. Much of the increase was driven by the use of COSA Teletrials methodology.
ABSTRACT
Introduction People with cancer are particularly vulnerable to COVID-19 and have been prioritised in vaccination programs. This group has reported concerns regarding the interactions between vaccines, cancer and anti-cancer treatments. We explored vaccine hesitancy in the disease-specific context of cancer Methods An online survey was conducted in Australia from June to October 2021. We developed a six-item scale assessing vaccine concerns in the context of chronic disease (Disease Influenced Vaccine Acceptance Scale DIVAS-6). Results There were 2691 evaluable responses;59% female, 71% from metropolitan areas, 36% with metastatic disease and 56% on current anti-cancer treatment. Commonest cancer types included breast 36.6%, genitourinary 18.6% and gastrointestinal 18%. Self-reported vaccine uptake was 80%. Overall, 57% agreed with the statement 'cancer makes me more worried about being infected with COVID-19.' Their doctor's recommendation regarding the vaccine was considered important by 79% of participants. 67% agreed with the statement that 'cancer means having the vaccine is more important.' This was different between vaccinated and unvaccinated participants (72% vs 46%). Unvaccinated participants had more concerns regarding vaccine efficacy (60% vs 34%), side effects (72% vs 29%) and interactions with anticancer treatment (53% vs 18%). Conclusions People with cancer have disease-specific concerns regarding COVID-19 vaccines. Use of DIVAS-6 can guide communication in this medically vulnerable population.
ABSTRACT
Introduction People with blood cancers are prioritised to receive COVID-19 vaccination. However, it is unclear how prevalent vaccine hesitancy is in this group. This analysis investigated vaccine uptake and vaccine hesitancy in people with blood cancers in Australia. Methods An online survey was conducted at nine health services in Australia from June to October 2021. Participant demographics and vaccination status were recorded. Vaccine hesitancy was assessed using the Oxford COVID-19 Vaccine Hesitancy Scale (OHS). Regression was used to examine whether clinico-demographic factors predicted the OHS score and vaccination status. Results Of the 869 participants, the mean age was 64.2 years, and 43.6% (n = 379) were female. A high proportion of participants had received at least one COVID-19 vaccine dose (85.3%, n = 741). Increasing age, speaking English as a first language, attending a regional health service, longer time since diagnosis and not currently receiving treatment were associated with being vaccinated. Participants who reported higher vaccine hesitancy were younger in age, more likely to have vocational qualifications and speak English as a second language. Conclusions There is a high rate of vaccination uptake in patients with blood cancers. However, younger patients and patients from culturally and linguistically diverse backgrounds appear to have lower vaccination uptake rates and higher levels of vaccine hesitancy. Tailored counselling may reduce the risk of adverse events due to COVID-19 infection.
ABSTRACT
Background: People with cancer are at higher risk of serious illness and death from COVID-19 infection. We investigated the differences in COVID-19 vaccine uptake and attitudes in people with various solid organ and hematological malignancies. Methods: An online survey of adult patients with cancer attending eight health services across four states in Australia, was conducted from June to September 2021. Demographics, cancer history and vaccination status were recorded. Only completed surveys were analysed. Variables were compared with chi-squared and multivariable analysis using logistic regression. Vaccine hesitancy was assessed using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford Vaccine Confidence and Complacency Scale, and the Monash Disease Vaccine Acceptance Scale. T-test analysis was used to examine relationships between the scales and groups. Results: There were 2997 evaluable responses;53.2% female, 61.8% from metropolitan areas, 27.5% with metastatic solid organ disease and 50.6% on current anti-cancer treatment. Patients with GI cancers comprised 13.5% (n = 405), compared with hematological 28.4%, breast 24.6%, genitourinary 14.1% and other cancer types 19.4%. Vaccination rates were significantly lower for respondents with GI cancers compared to other cancer types (71.6% v 79.3%;p< 0.001). Significant differences in the GI cancer population compared to all others were: more males (p < 0.001), lower level of education (p= 0.001), fewer reporting English as first language (p = 0.02) and shorter time since cancer diagnosis (p < 0.001). These remainedsignificant after logistic regression. Among GI cancer respondents, factors associated with being vaccinated compared to unvaccinated included: older age (p < 0.001), higher education level (p = 0.03) and English as first language (p = 0.01). There was no significant difference in the scales measuring vaccine hesitancy, confidence and complacency, for the GI cancer population compared to other cancers. As expected, there were significant differences in all scales comparing vaccinated to unvaccinated respondents with GI cancers. Conclusions: In our large, contemporary survey, Australians with GI cancers report lower COVID19 vaccine uptake compared with patients with other cancer types. We identified demographic and disease related characteristics that contribute to these differences. Interventions and targeted communication are required for people with GI cancers to maximise vaccination uptake in this medically vulnerable group.