COVID vaccine acceptance in inner-city minority cancer population.
Authors: Yim Barbara , Maklad Khaled , Sherazi Syed Ali Amir , Tariq Muhammad Junaid , Usman Muhammad , Gupta Shweta 
Published: September 2021

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Background: COVID-19 pandemic has caused delay in cancer diagnosis and treatment risking increase in cancer-related mortality. COVID vaccines offer hope to control pandemic and ensure uninterrupted cancer care. Per CDC, as of May 25, 2021, vaccination rates for minorities, especially African Americans (AA) and Hispanics (HISP) have lagged behind (https://covid.cdc.gov/covid-data-tracker/#vaccination-demographic). Our study was undertaken to explore attitudes of Chicago’s inner-city minority cancer population towards COVID-19 vaccination when vaccines became available (Dec 2020) and 5 months later (May 2021). Methods: Cook County Health is a large public health care system in the USA. A voluntary brief 15 question anonymous survey was offered at clinic intake by the Medical Assistant (MA) in Oncology and Hematology clinics for 1 month starting December 16, 2020. The survey was IRB exempt. A follow up one-question survey was given for 1 week in May 2021 at one MA intake station asking if patients had received or planned to receive the vaccine. No identifying information was collected. Results: Initial phase: A total 505 completed surveys were received consisting of 199 (39%) AA, 201 (40%) HISP, 51 (10%) Whites, 38 (8%) Asians and 3% other. There were 58% women, 58% patients with education high-school/less and 91% with annual household income <$40,000. Overall, 320 (63%) patients were agreeable to take/consider taking the vaccine now, if available, 134 (26.5%) wanted to wait and see while 51 (10%) absolutely refused the vaccine. Reasons for hesitation (wait and see) were vaccine being experimental (51%) and not wanting to be the first to receive (49%), not trusting the vaccine information (16%). Reasons for absolutely refusing were vaccine being experimental (75%) and not trusting the information (47%), did not believe in vaccines (12%). About 62% of AA, 69% HISP, 68% Asians and 49% Whites were agreeable to the COVID vaccine (p<0.05). Wait and see was reported by 26% AA, 25% HISP, 32% Asians and 29% Whites (p=NS). Absolute denials were 12%, 6% and 22% among AA, HISP and Whites respectively (p<0.05). The most common reason for denial for all 3 groups was belief that vaccine was still experimental (71% AA, 85% HISP and 73% Whites). The second most common reason reported for denial was mistrust of the vaccine information reported by 50% AA, 38% HISP and 36% Whites respectively. Second phase: Of 162 consecutive patients asked if they had received the vaccine, 119 (73%) had received 1 or both vaccine doses, 18 (11%) were planning to receive it while 26 (16%) had no plans to get vaccinated as yet. Conclusions: Unlike national vaccination rates, inner-city minority cancer population has been very accepting of the COVID vaccines as evidenced by high vaccination rates. AA and Hispanics were more open to vaccination than whites. These high rates in AA and HISP is especially encouraging considering this population has historically had lower reported vaccination rates.