Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Dipartimento di Medicina Clinica e Molecolare, Università La Sapienza di Roma, Rome, Italy.
Eur J Cancer. 2021 Aug;153:260-264. doi: 10.1016/j.ejca.2021.05.006. Epub 2021 May 26.
Patients with cancer have an increased risk of complications from coronavirus disease 2019 (COVID-19) infection, including death, and thus, they were considered as high-priority subjects for COVID-19 vaccination. We report on the compliance with the COVID-19 vaccine of patients affected by solid tumours.
Patients with cancer afferent to Medical Oncology 1 Unit of Regina Elena National Cancer Institute in Rome were considered eligible for vaccination if they were receiving systemic immunosuppressive antitumor treatment or received it in the last 6 months or having an uncontrolled advanced disease. The Pfizer BNT162b2 vaccine was proposed to all candidates via phone or during a scheduled visit. The reasons for refusal were collected by administrating a 6-item multiple-choice questionnaire.
From 1st March to 20th March 2021, of 914 eligible patients, 102 refused vaccination (11.2%, 95% confidence interval [CI] 9.1-13.2). The most frequent (>10%) reasons reported were concerns about vaccine-related adverse events (48.1%), negative interaction with concomitant antitumor therapy (26.7%), and the fear of allergic reaction (10.7%). The refusal rate (RR) after 15th March (date of AstraZeneca-AZD1222 suspension) was more than doubled compared with the RR observed before (19.7% versus 8.6%, odds ratio [OR] 2.60, 95% CI 1.69-3.99; P < 0.0001). ECOG-PS 2 was associated with higher RR compared with ECOG-PS 0-1 (OR 2.94, 95% CI 1.04-8.34; P = 0.04). No statistically significant differences in RR according to other clinical characteristics were found.
Our experience represents the first worldwide report on the adherence of patients with cancer to COVID-19 vaccination and underlines how regulatory decisions and media news spreading could influence the success of the campaign.
患有癌症的患者感染 2019 年冠状病毒病（COVID-19）的并发症风险增加，包括死亡，因此，他们被认为是 COVID-19 疫苗接种的高优先级人群。我们报告了实体瘤患者对 COVID-19 疫苗的接种依从性。
如果患者正在接受全身免疫抑制抗肿瘤治疗，或在过去 6 个月内接受过治疗，或患有无法控制的晚期疾病，则认为罗马 Regina Elena 国家癌症研究所医学肿瘤学 1 科的癌症患者有资格接种疫苗。向所有符合条件的候选人通过电话或预约就诊时推荐 Pfizer BNT162b2 疫苗。通过管理 6 项多项选择问卷收集拒绝接种疫苗的原因。
从 2021 年 3 月 1 日至 3 月 20 日，在 914 名符合条件的患者中，有 102 人拒绝接种疫苗（11.2%，95%置信区间[CI]为 9.1-13.2）。报告的最常见（>10%）原因是对疫苗相关不良反应的担忧（48.1%）、与同时进行的抗肿瘤治疗相互作用（26.7%）以及对过敏反应的恐惧（10.7%）。与 3 月 15 日（AstraZeneca-AZD1222 暂停使用日期）之前相比，15 日之后的拒绝率（RR）翻了一番多（19.7%比 8.6%，比值比[OR]为 2.60，95%CI 为 1.69-3.99；P<0.0001）。与 ECOG-PS 0-1 相比，ECOG-PS 2 与更高的 RR 相关（OR 2.94，95%CI 1.04-8.34；P=0.04）。根据其他临床特征，RR 没有统计学上的显著差异。
我们的经验代表了全球首例关于癌症患者对 COVID-19 疫苗接种的依从性的报告，并强调了监管决策和媒体新闻传播如何影响疫苗接种运动的成功。
