Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
University of Utah School of Medicine, Salt Lake City, UT, USA.
J Cancer Educ. 2023 Apr;38(2):562-570. doi: 10.1007/s13187-022-02155-x. Epub 2022 Mar 28.
Survivors of adolescent and young adult (AYA) cancer are susceptible to severe COVID-19 outcomes due to their cancer history. Drivers of COVID-19 vaccine hesitancy and willingness are largely unexplored among AYA cancer survivors.
We surveyed survivors of AYA cancer from October 2020-February 2021 who received services through an AYA cancer care program. Survey measures included vaccine hesitancy on a five-point Likert scale and an open-ended question on vaccine intent. Open-ended responses were content analyzed through two cycles of structured coding. Quantitative vaccine intent and qualitative drivers of intent were integrated during data analysis.
Of participants who responded to the open-ended vaccine intent question (N = 300), 39.0% reported COVID-19 vaccine hesitancy. Qualitative content analysis resulted in N = 517 codes and seven content categories. The most common content category associated with hesitancy included COVID-19 vaccine development, approval, and efficacy (34.5%; p value ≤ 0.001), as well as content areas including presence of misinformation about COVID-19 in the response (4.8%; p value = 0.04), the desire for more information about COVID-19/COVID-19 vaccine (6.0%; p value ≤ 0.001), and reference to political influence on participants' intent to get the vaccine (2.5%; p value = 0.005). The most common category associated with vaccine willingness was personal perceptions of COVID-19 vaccination including protecting oneself and others (36.6% of codes; p value ≤ 0.001), followed by pro-vaccine beliefs (8.3%; p value ≤ 0.001) and trust in science (3.9%; p value ≤ 0.001).
Common drivers of COVID-19 vaccine hesitancy among survivors of AYA cancer include concern about vaccine side effects and approval process, and misinformation. Cancer survivors COVID-19 vaccine uptake could be improved by focusing communication on drivers of willingness, motivational interviewing, and physician recommendations.
青少年和年轻成人（AYA）癌症幸存者由于其癌症病史，易发生严重的 COVID-19 后果。AYA 癌症幸存者中，COVID-19 疫苗犹豫和意愿的驱动因素在很大程度上尚未得到探索。
我们于 2020 年 10 月至 2021 年 2 月期间调查了通过 AYA 癌症护理计划接受服务的 AYA 癌症幸存者。调查措施包括对 COVID-19 疫苗的犹豫程度进行五分制李克特量表评估，以及对疫苗接种意愿的开放式问题。对开放式回答进行了两轮结构化编码的内容分析。在数据分析过程中，将定量疫苗接种意愿和定性接种意愿驱动因素进行了整合。
对开放式 COVID-19 疫苗接种意愿问题作出回应的参与者中（n=300），39.0%的人表示对 COVID-19 疫苗犹豫不决。定性内容分析产生了 n=517 个代码和七个内容类别。与犹豫最相关的常见内容类别包括 COVID-19 疫苗的开发、批准和功效（34.5%；p 值≤0.001），以及与 COVID-19 相关的错误信息存在于应对措施中（4.8%；p 值=0.04）、希望获得更多关于 COVID-19/COVID-19 疫苗的信息（6.0%；p 值≤0.001），以及提到政治因素影响参与者接种疫苗的意愿（2.5%；p 值=0.005）。与接种疫苗意愿最相关的常见类别是个人对 COVID-19 疫苗接种的看法，包括保护自己和他人（36.6%的代码；p 值≤0.001），其次是支持疫苗接种的信念（8.3%；p 值≤0.001）和对科学的信任（3.9%；p 值≤0.001）。
AYA 癌症幸存者中 COVID-19 疫苗犹豫的常见驱动因素包括对疫苗副作用和批准过程以及错误信息的担忧。通过关注意愿驱动因素、动机访谈和医生建议，可以提高癌症幸存者对 COVID-19 疫苗的接种率。
