Psychological impact of COVID-19 vaccination in patients with cancer: The VACCINATE study.
Authors: Tregnago Daniela , Avancini Alice , Belluomini Lorenzo , Trestini Ilaria , Sposito Marco , Insolda Jessica , Bianchi Federica , Sava Teodoro , Gaiani Chiara , Del Piccolo Lidia , Guarnieri Valentina , Verlato Giuseppe , Tfaily Ahmad , Vesentini Roberta , Zuliani Serena , Bria Emilio , Pilotto Sara , Milella Michele 
Published: June 2023

e24207

Background: Measures adopted to contain COVID-19 may impact cancer pts' psychological well-being and clinical status. We assessed the psychological status and attitude towards COVID-19 vaccination in adult cancer pts who accepted vaccination at the University and Hospital Trust of Verona and Camposampiero Hospital in the Veneto region. Methods: A self-reported questionnaire was administered to pts undergoing the first and second dose of COVID-19 vaccination in the context of the vaccination campaign promoted by the Veneto Oncology Network (Rete Oncologica Veneta - ROV) between March and May 2021. Overall, 27 items were investigated: i) demographics/clinical characteristics; ii) psychological status (Hospital Anxiety and Depression Scale - HADS - and Distress Thermometer - DT); iii) awareness about infection risks, interference with anticancer treatments, and vaccine side effects. Results: Overall, only 2.5% of the invited active oncological population refused COVID-19 vaccination. Data collected in both Verona and Camposampiero (1089 and 286 respondents, respectively) demonstrated borderline and clinical levels of anxiety in 14% and 10% of pts, borderline and clinical levels of depression in 14% and 8% of pts; and moderate and severe distress levels in 33% and 9% of pts, respectively. No significant differences between the two sites and between the first and second dose were observed, with the exception of significantly lower levels of distress at the time of the second dose administration at the Camposampiero site. In the Verona cohort, clinical anxiety was significantly more frequent in breast cancer and rare tumor pts (17.5% and 21.4%, respectively; p= 0.005); no significant associations were found for depression and distress. Overall, there was high confidence that vaccination would reduce the risk of contracting COVID-19 (70%), which would make pts feel less worried about contracting the infection (60%); among pts with borderline and clinical depression levels, there was less confidence that vaccination would "make [them] feel less worried to contract COVID-19" ["Not at all" or "Only a little" in 16.2% and 20% of pts with borderline and clinical depression levels, respectively, as opposed to 6.6% among pts with normal depression levels (p = 0.005)]. Fear that vaccine-related side effects would interfere with anticancer treatment and/or global health status was low (10% and 9% for items 3 and 4, respectively) and significantly associated with baseline psychological status at multivariate analysis. Similar results were obtained in the Camposampiero cohort. Conclusions: During the COVID-19 vaccination campaign, adult cancer pts demonstrated high levels of confidence towards vaccination; baseline psychological status was the only significant predictor of reduced confidence.