Most Breast Cancer Patients May Be Open to Receiving COVID-19 Vaccine

By Linda Carroll

June 11, 2021

(Reuters Health) - A survey of women with breast cancer who had recently visited social media channels dedicated to breast cancer care found that a majority were willing to be vaccinated against COVID-19 immediately, while one third were hesitant.

The survey data from 540 unvaccinated women with breast cancer revealed that many of those who were hesitant would be more willing to take the vaccine if it were recommended by their oncologist and if they had more information on its efficacy, researchers report in JAMA Oncology.

"Vaccine hesitancy is a major public health concern worldwide because COVID-19 herd immunity remains the most important strategy for tackling the pandemic and reducing patients' risk of developing a severe disease," said the study's lead author Dr. Cynthia Mayte Villarreal-Garza, medical oncology chief of the Breast Cancer Center at Hospital Zambrano Hellion TecSalud in San Pedro Garza García, Mexico.

"One possible explanation for the high rate of vaccine hesitancy seen in this population could be the scarce information about the vaccines' efficacy and safety in patients with cancer. Oncologists and healthcare workers need to address any misconceptions that patients could have in order to promote vaccine acceptance," she noted.

This kind of vaccine hesitancy is a "global issue," Dr. Villarreal-Garza said in an email.

"It is imperative to develop strategies that effectively communicate the benefits of getting vaccinated against COVID-19 and increase vaccine literacy among oncologic patients," Dr. Villarreal-Garza said. "Oncologists and healthcare workers should actively discuss with their patients the benefits of getting vaccinated against COVID-19 and solve any misconception that they could have. As shown by our study findings, the motives that could increase vaccine acceptance in hesitant patients are that oncologists recommend their patients to get vaccinated and that patients have more information about the effectiveness and safety of COVID-19 vaccines."

In March 2021, to get a better sense of attitudes toward the vaccine among breast cancer patients, Dr. Villarreal-Garza and her colleagues invited women with breast cancer residing in Mexico who visited the social media channels of nongovernmental organizations dedicated to improving breast cancer care to complete a web-based survey.

To assess COVID-19 vaccine hesitancy rates, the researchers dichotomized participants into a vaccine-acceptant group who were willing to be vaccinated immediately, and a vaccine-hesitant group who preferred to wait, were only willing to be vaccinated if it was mandatory, or completely refused.

The analysis included 540 women who had not already been vaccinated, with a median age of 49 years, of whom 357 (66%) said they were willing to be vaccinated immediately. Of the 183 (34%) who said they weren't ready to be vaccinated, 142 (26%) said they would wait to see the vaccine's adverse effects in others, 23 (4%) said they would only be vaccinated if it became mandatory, and 18 (3%) said they would refuse to be vaccinated.

The most common reasons for vaccine acceptance were: protection against COVID-19 (301, 84%), to take care of their relatives (227, 64%), a self-perceived sense of social responsibility (227, 64%), a fear of getting seriously ill (217, 61%), and/or a desire for "getting back to normal" (186, 52%).

Factors associated with vaccine hesitancy included mistrust in the healthcare system (odds ratio 8.79), a misconception that COVID-19 vaccination is contraindicated in patients with breast cancer (OR 8.41), not having a close acquaintance already vaccinated against COVID-19 (OR 2.63), noncompliance with prior influenza immunization (OR 2.27), age younger than 60 years (OR 2.01), low educational attainment (OR 1.84), and not having a close acquaintance deceased from COVID-19 (OR 1.5).

The new study was "intriguing" to Dr. Jessica Justman, an associate professor of medicine in epidemiology at Columbia University's Mailman School of Public Health in New York City and senior technical director of ICAP.

Still, Dr. Justman noted, "it's important to recognize that this is not necessarily a nationally representative sample, so they don't really know how well it represents women with breast cancer in Mexico. They did not talk about that in the piece and it's something I'd like to ask them."

"But this kind of convenience sampling strategy is fast and simple to do and they did get a decent sample size," Dr. Justman said. "I found it encouraging that two-thirds of the women were categorized as vaccine accepting and only one third were vaccine hesitant and two-thirds of those women said that having their oncologist recommend the vaccine would motivate them. So it's something that's within reach. That's encouraging."

SOURCE: https://bit.ly/3gsZurs JAMA Oncology, online June 10, 2021.

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