Impact Factors of COVID-19 Vaccination Hesitancy in patients after lung cancer surgery: an outpatients-based cross-sectional study (preprint)

ABSTRACT

Background The safety and efficacy of several vaccine candidates have been tested and found to be effective and safe against COVID-19. But, little is known about the actual level of people with lung cancer willing to accept a COVID-19 vaccine and the impact factors that affect acceptability. The survey aimed to determine the prevalence of vaccine hesitancy in lung cancer patients after surgery and characterize underlying factors contributing to reluctance.Methods An clinical survey was inducted from May 1, 2021, to August 20, 2021. Eligible participants were 18 years or older, were diagnosed with lung cancer, and received lung cancer surgery, including lobectomy, sublobectomy, and pneumonectomy. Data were collected on a self-administered questionnaire from 294 lung cancer patients after surgery.Results Among the final included 281 participants, 54.1% were female, and 93.6% were of Han ethnicity. 48.0% were in pathologic stage I, 36.3% in stage II, 10.3% in stage III, and 5.3% in stage IV. The vaccination hesitancy/refusal rate was 41.6%. In multivariable regression analysis, age over 60 years old, low educational level, duration of cancer (< 1 year), subjective health status, current cancer treatments use, presence of postoperative pain, and report of the items “ever hesitated or refused to get a vaccination,” “get negative information about getting the COVID-19 vaccine”, “worried about vaccine adverse reactions,” and “worried about the COVID vaccine interferes with cancer treatments” were independently associated with hesitant of the COVID-19 vaccine.Conclusions Vaccine hesitancy is common among lung cancer patients after surgery, related mainly to health status and concerns about side effects, worsens cancer prognosis, and interferes with cancer treatments. These results suggest that vaccination programs may need tailoring to specific populations’ hesitancy.