School of Public Health, Shantou University, Shantou, China.
Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China.
Front Public Health. 2023 Aug 3;11:1236376. doi: 10.3389/fpubh.2023.1236376. eCollection 2023.
It is essential to protect cancer patients from contracting COVID-19 through vaccination. A majority of cancer patients are recommended by international health authorities to take up the vaccines. COVID-19 vaccine refusal among cancer patients during the pandemic period is under-researched. This study investigated factors of vaccine refusal based on the Health Belief Model (HBM).
A cross-sectional study was conducted among female breast cancer patients, male/female thyroid cancer patients, and gynecological cancer patients in Shantou, China from April to August 2022 ( = 1,115). Multinomial logistic regression analysis adjusted for socio-demographics was conducted to test factors of COVID-19. Adjusted odds ratios of the two models comparing vaccine refusal vs. "vaccine non-refusal" and vaccine refusal vs. ever-vaccination were derived and presented.
Of all the participants, the prevalence of vaccine refusal, "vaccine non-refusal," and ever-vaccination was 25.9, 22.2, and 51.8%, respectively. In both multinomial logistic regression models, significant factors of vaccine refusal included socio-demographics (age, education level, employment status, monthly household income, cancer type, duration since cancer diagnosis, current treatment status) and some vaccine-related HBM (perceived benefits, perceived barriers, cue to action, and self-efficacy). Perceived severity of COVID-19 was significant only in the vaccine refusal vs. ever-vaccination model. In neither model, perceived susceptibility to contract COVID-19 was statistically significant.
About ¼ of the participants expressed vaccine refusal. Interventions are warranted. Future longitudinal studies are needed to verify this study's findings. Pilot interventions should also be launched to test effectiveness of interventions modifying the significant HBM factors found in this study.
通过接种疫苗来保护癌症患者免受 COVID-19 的感染至关重要。国际卫生当局建议大多数癌症患者接种疫苗。在大流行期间，针对癌症患者的 COVID-19 疫苗拒绝接种的研究还比较少。本研究基于健康信念模型（HBM）调查了疫苗拒绝接种的因素。
2022 年 4 月至 8 月，在中国汕头对女性乳腺癌患者、男性/女性甲状腺癌患者和妇科癌症患者进行了横断面研究（n=1115）。采用多变量逻辑回归分析调整了社会人口统计学因素，以检验 COVID-19 相关因素。并呈现了两个模型中比较疫苗拒绝与“疫苗非拒绝”以及疫苗拒绝与既往接种疫苗的调整后优势比。
在所有参与者中，疫苗拒绝、“疫苗非拒绝”和既往接种疫苗的比例分别为 25.9%、22.2%和 51.8%。在两个多变量逻辑回归模型中，疫苗拒绝的显著因素包括社会人口统计学因素（年龄、教育水平、就业状况、月家庭收入、癌症类型、癌症诊断后时间、当前治疗状况）和一些疫苗相关的 HBM（感知益处、感知障碍、提示行动和自我效能）。COVID-19 的感知严重性仅在疫苗拒绝与既往接种疫苗模型中具有统计学意义。在这两个模型中，对感染 COVID-19 的感知易感性均无统计学意义。
约有 1/4 的参与者表示拒绝接种疫苗。需要采取干预措施。未来需要进行纵向研究来验证本研究的结果。还应开展试点干预，以测试针对本研究发现的有意义的 HBM 因素进行干预的效果。
