Individual-level factors associated with COVID-19 vaccine acceptance among U.S. patients with cancer

ABSTRACT

Introduction Vaccine hesitancy in the wake of the COVID-19 pandemic is a major public health concern in the US. Cancer patients are especially vulnerable to adverse COVID-19 outcomes and require targeted prevention efforts against COVID-19. Methods We used longitudinal survey data from patients seen at Moffitt Cancer Center to identify attitudes, beliefs, and sociodemographic factors associated with COVID-19 vaccination acceptance among cancer patients. Patients with confirmed invasive cancer diagnosis through Cancer Registry data were asked about vaccine acceptance through the question “Now that a COVID-19 vaccine is available, are you likely to get it?” and dichotomized into high accepters (already received it, would get it when available) and low accepters (waiting for a doctor to recommend it, waiting until more people received it, not likely to get it). Results Most patients (86.8% of 5,814) were high accepters of the COVID-19 vaccine. High accepters had more confidence in the effectiveness and safety of the vaccine than low accepters. Multivariable logistic regression showed older individuals (70-89 vs.18-49 OR2.57, 95% CI1.33-4.86), those with greater perceived severity of COVID-19 infection (very serious vs. not at all serious OR2.55, 95% CI1.76-3.70), practicing more risk mitigation behaviors (per one standard deviation OR1.75, 95% CI1.57-1.95), and history of receiving the flu shot versus not (OR6.56, 95% CI5.25-8.20) had higher odds of vaccine acceptance. Individuals living with more than one other person (vs. alone OR 0.53, 95% CI 0.35, 0.79) and those who were more socioeconomically disadvantaged (per 10 percentile points OR 0.89, 95%CI 0.85, 0.93) had lower odds of reporting vaccine acceptance. Conclusion Most patients with cancer have or would receive the COVID-19 vaccine. Those who are less likely to accept the vaccine have more concerns regarding effectiveness and side effects, are younger, more socioeconomically disadvantaged, and have lower perceptions of COVID-19 severity.