Xiaoyuan Pan, Xinyu Zhu, Zhengbang Dong
Department of Dermatology, Zhongda Hospital, Southeast University, Nanjing, China.
Department of Dermatology, Jinshan Hospital, Fudan University, Shanghai, China.
J Cancer Educ. 2025 Jul 1. doi: 10.1007/s13187-025-02668-1.
To assess the awareness, attitudes, and practice related to Herpes Zoster (HZ) and its vaccines among cancer patients from two tertiary hospitals in China, and explore the factors influencing the perceived necessity of vaccination against HZ. This was a multi-center cross-sectional study involving cancer patients from two tertiary hospitals in China from January to April 2024. A self-designed questionnaire was used to survey the baseline characteristics, awareness, attitudes and practice about HZ and its vaccines, and factors influencing the perceived necessity of vaccination against HZ. A total of 392 cancer patients were included in the study, with an overall awareness score towards HZ and its vaccines of 4.79 ± 2.36 points, and an overall attitude score of 11.69 ± 2.32 points. The awareness score towards HZ and its vaccines was negatively correlated with male gender (β = -0.51, P < 0.001), 50-59 years of age (β = -1.43, P = 0.001), ≥ 60 years of age (β = -1.84, P < 0.001), and divorced/widowed (β = -1.29, P = 0.018). It was positively correlated with higher education level (β = 0.62, P = 0.035), annual household income (AHI) ≥ 100,000-150,000 RMB (β = 0.89, P = 0.012), AHI > 150,000 RMB (β = 1.64, P = 0.002), urban residency (β = 0.72, P = 0.002), diabetes (β = 1.41, P = 0.001), and history of chickenpox (β = 0.56, P = 0.011). The attitude score towards HZ and its vaccines was negatively correlated with male gender (β = -0.67, P = 0.006) and uncertain history of chickenpox (β = -1.2, P = 0.005), while positively correlated with AHI > 150,000 RMB (β = 1.89, P < 0.001), history of HZ (β = 0.66, P = 0.013), and information source from community healthcare providers (β = 1.7, P < 0.001). The HZ vaccination rate was only 1.79% in the overall cohort, and 3.68% among older adults aged ≥ 50 years. Nearly half of participants (49.17%) ignored the significance of vaccination against HZ mainly due to the unawareness of HZ vaccine availability, and concerns about side effects. Misconceptions about an increased susceptibility to HZ in immunocompromised individuals, complications and prevention of HZ were the dominant factors influencing the perceived necessity of vaccination. While possessing a strong belief in the vaccine efficacy against HZ, the vaccination rate remains extremely low in Chinese cancer patients due to a low awareness of HZ and its vaccines. The education of vaccination against HZ by community healthcare providers is a promising way to increase the willingness to get vaccinated, particularly in the elderly, and those with low educational levels, and low AHI.
为评估中国两家三级医院癌症患者对带状疱疹（HZ）及其疫苗的知晓情况、态度和行为，并探讨影响HZ疫苗接种必要性认知的因素。这是一项多中心横断面研究，纳入了2024年1月至4月来自中国两家三级医院的癌症患者。采用自行设计的问卷对患者的基线特征、对HZ及其疫苗的知晓情况、态度和行为，以及影响HZ疫苗接种必要性认知的因素进行调查。本研究共纳入392例癌症患者，对HZ及其疫苗的总体知晓得分是4.79±2.36分，总体态度得分为11.69±2.32分。对HZ及其疫苗的知晓得分与男性（β=-0.51，P<0.001）、50-59岁（β=-1.43，P=0.001）、≥60岁（β=-1.84，P<0.001）以及离异/丧偶（β=-1.29，P=0.018）呈负相关。与较高教育水平（β=0.62，P=0.035）、家庭年收入（AHI）≥100,000-150,000元（β=0.89，P=0.012）、AHI>150,000元（β=1.64，P=0.002）、城市居住（β=0.72，P=0.002）、糖尿病（β=1.41，P=0.001）以及水痘病史（β=0.56，P=0.011）呈正相关。对HZ及其疫苗的态度得分与男性（β=-0.67，P=0.006）和水痘病史不确定（β=-1.2，P=0.005）呈负相关，与AHI>150,000元（β=1.89，P<0.001）、HZ病史（β=0.66，P=0.013）以及社区医疗服务提供者的信息来源（β=1.7，P<0.001）呈正相关。总体队列中HZ疫苗接种率仅为1.79%，50岁及以上老年人中为3.68%。近一半的参与者（49.17%）忽视了HZ疫苗接种的重要性，主要原因是不了解HZ疫苗的可及性以及对副作用的担忧。对免疫功能低下个体HZ易感性增加、HZ并发症及预防的误解是影响疫苗接种必要性认知的主要因素。尽管对HZ疫苗的有效性坚信不疑，但由于对HZ及其疫苗的知晓率低，中国癌症患者的疫苗接种率仍然极低。社区医疗服务提供者开展HZ疫苗接种教育是提高接种意愿的有效途径，尤其是对老年人、教育水平低和AHI低的人群。
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