Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
Gehr Family Center for Health Systems Science, University of Southern California, Los Angeles, California, USA.
Cancer Med. 2024 Nov;13(22):e70428. doi: 10.1002/cam4.70428.
Cancer survivors are considered by public health officials as a high-risk group in the United States for severe complications from COVID-19. We aimed to characterize patterns of early uptake of the COVID-19 vaccine among cancer survivors and to determine modifiable barriers to vaccine completion that can be addressed to ensure future booster adherence.
Cross-sectional data of vaccine uptake by summer 2021 was extracted from adult cancer survivors enrolled in the "All of Us" research program. Vaccine completion was determined based on receiving at least two doses. We assessed sociodemographic factors, socioeconomic barriers (education, income, health insurance status, housing, and employment status), and COVID-19 vaccine uptake by Summer 2021, employing multivariable ordinal logistic regression for those who were unvaccinated, had initiated vaccine uptake, and had completed COVID-19 vaccination.
Of the 514 cancer survivors in the sample, 73.7% were fully vaccinated by summer 2021. Those who received no vaccine doses showed higher proportions of SES barriers, medical distrust, and perceived lack of need barriers. Race (non-Hispanic White vs. other) was not statistically significantly associated with vaccine uptake (OR (95% CI) = 0.94 (0.51, 1.70)), while for every additional SES barrier, there was a 40% decrease (OR (95% CI) = 0.60 (0.48, 0.75)) in the odds of receiving more COVID-19 vaccine doses. Higher medical distrust and perceived lack of need were associated with 56% (OR = 0.44, 95% CI: 0.32-0.59) and 39% (OR = 0.61, 95% CI: 0.43-0.87) lower odds, respectively.
Racial/ethnic disparities in vaccine uptake may be explained by SES barriers. Addressing SES disparities and fostering medical trust may enhance future COVID-19 vaccination uptake rates for this high-risk group.
在美国，癌症幸存者被公共卫生官员视为 COVID-19 严重并发症的高风险群体。我们旨在描述癌症幸存者早期接种 COVID-19 疫苗的模式，并确定可解决的疫苗接种完成障碍，以确保未来的加强针接种依从性。
从参加“所有人”研究计划的成年癌症幸存者中提取了截至 2021 年夏季的疫苗接种情况的横断面数据。根据至少接种两剂疫苗来确定疫苗接种完成情况。我们评估了社会人口因素、社会经济障碍（教育、收入、医疗保险状况、住房和就业状况）以及截至 2021 年夏季的 COVID-19 疫苗接种情况，对于未接种疫苗、已开始接种疫苗和已完成 COVID-19 疫苗接种的人群，采用多变量有序逻辑回归进行评估。
在样本中的 514 名癌症幸存者中，73.7%在 2021 年夏季前完全接种了疫苗。未接种疫苗的人群中，社会经济障碍、医疗不信任和感知到的无需接种疫苗的比例更高。种族（非西班牙裔白人与其他族裔）与疫苗接种率无统计学显著关联（OR（95%CI）=0.94（0.51，1.70）），而每增加一个社会经济障碍，接种更多 COVID-19 疫苗的几率就会降低 40%（OR（95%CI）=0.60（0.48，0.75））。较高的医疗不信任和感知到的无需接种疫苗的情况与接种疫苗的几率分别降低 56%（OR=0.44，95%CI：0.32-0.59）和 39%（OR=0.61，95%CI：0.43-0.87）相关。
疫苗接种率的种族/民族差异可能由社会经济障碍解释。解决社会经济差异和培养医疗信任可能会提高这一高风险群体未来 COVID-19 疫苗接种率。
