Assessment of COVID vaccine knowledge and hesitancy in an ethnic minority oncology patient population

ABSTRACT

Background: Complicating the pandemic are the healthcare disparities experienced by ethnic minorities, including Black and Hispanic Americans. This is further exacerbated in those ethnic subgroups, especially if they have comorbidities, including cancer. With the introduction of COVID-19 vaccines, the shift is now focused on promoting vaccination. However, vaccine hesitancy and motives of why ethnic minority cancer patients receive or do not receive vaccines have not been explored and are the focus of this study. Methods: A cross-sectional survey was administered among cancer patients to understand the knowledge and attitude towards COVID-19 vaccines at a single institution in a predominantly ethnic minority population between February 1-June 30, 2021. The participant's inclusion criteria were >18 years old and diagnosed with solid or hematologic malignancy. Descriptive statistics were used to summarize the patient characteristics, COVID-19 vaccine knowledge, and uptake motives. A composite score of COVID-19 and vaccine knowledge was derived and its role on vaccination status was assessed using a multivariable logistic regression model. Results: Of 52 patients surveyed, COVID-19 vaccination prevalence during the survey was 40.4% (95% CI 27, 54.9). Participants' average (sd) age was 63.5 (13.6) years;42% were male, 36% were Black, and 30% Hispanic;65% were receiving active treatment for their cancer. Seventy-nine percent believed COVID-19 infection to be dangerous or harmful to them, 61% were concerned about the side effects of the COVID-19 vaccine, yet 65% considered vaccines safe. Those refusing the vaccine (n=7) cited side effects (71%) or believed that the vaccine was not needed (57%). Of those who were unvaccinated (n=31), 48.4% (n=15) got vaccinated post-survey. The odds of vaccination was 3.79 (1.63, 8.82) times higher with a 1 unit increase in COVID-19 knowledge score but was not significant in the multivariable model. The final model suggested that the odds of vaccination increased 2.9 times more for a 1 unit increase in vaccine knowledge score;Blacks were two times more likely to get vaccinated and those with more than high school education had a five-fold increase in vaccination. The model results are presented in Table. Conclusions: This exploratory study has demonstrated that there are multiple reasons why an ethnic minority cancer patient would be vaccinated and possible reasons why they would not. This information will become important in improving vaccine campaigns targeting these populations and ensuring their safety and protection against COVID-19.