People with cancer are likely to accept the COVID-19 vaccine, but politics tracks with attitudes: An inspire and COSMO survey.
Authors: Dizon Don S. , Hoffman Kathleen D. , Gentile Danielle , Tsai Richard , Novack John , Attai Deanna J. , Markham Merry Jennifer , Hylton Heather Marie , Schapira Lidia , Graham David L. , Thompson Michael A. ,   Collaboration for Outcomes using Social Media in Oncology (COSMO)
Published: June 2021

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Background: Vaccines are a major step towards control of the COVID-19 pandemic. Estimates from multiple surveys of the general public indicate that 40 to 60% plan to be vaccinated, with some data suggesting that uptake differs by political leanings. The views of people with cancer on COVID-19 vaccination have not been reported. We report survey results of people with cancer, evaluating intent and attitudes toward COVID-19 vaccinations. Methods: An online survey included self-identified patients with cancer, ≥18 years old, in the Inspire Online Community (www.inspire.com). Invitation was restricted to only members of Inspire’s cancer support groups who agreed to be contacted for research. Quantitative data were summarized with descriptive statistics. Data were analyzed by chi-square, ANOVA, and post hoc Tamhane’ T2 testing. Results: 750 responded with the most common cancers represented being prostate (30%), thyroid (24%) ovarian (20%), bladder (8%) and breast (4%). 44% were between 46 and 65 years old and 48% were over 65. Of these, 38% reported being on active treatment. The majority were white (91%), female (56%) and had a bachelor’s degree or higher (72%). Respondents represented the South (38%), West (28%), Midwest (20%), and Northeast (18%). Nearly half of respondents lived in a suburb near a large city. Almost 40% reported an annual income of > $100,000 and 13% reported income < $50,000/year. The proportion that would “definitely” or “most probably” get the COVID-19 vaccine was 80%, with significantly greater interest in people with prostate (85%), bladder (82%) and ovarian cancer (81%). Those with breast cancer reported the highest levels of being uncertain (23%) and 30% of those with thyroid cancer reported they would “probably” or “definitely” not get vaccinated. Older age, male sex, and college graduates were significantly more likely to get vaccinated. Concerns about side effects were reported by 54%, with younger patients significantly more concerned than those 66 years and older. Of 158 participants who listed other reasons they would not get vaccinated, 23% were concerned that the research and development was rushed and 11% worried about how it might interact with a compromised immune system. Using the 2020 Electoral College map to indicate political leaning at the state level, there was no significant difference in vaccine uptake, although significantly more people from blue states agreed that vaccination was the best defense against COVID-19 compared to those from red states (67 vs 33%, p <.05). Conclusions: People with cancer are much more interested in COVID-19 vaccination compared to the general public. Despite this, a large percentage of people with cancer reported distrust in either the government and/or the healthcare industry. Although vaccine attitudes tracked with political leanings at the state level, intention to get vaccinated did not.