Abstract 807: RSV vaccine hesitancy among southern rural veterans with cancer in the Arkansas-Louisiana-Texas (ArkLATX) region: The impact of vaccine fatigue
Authors: Philip A. Haddad, Crystal Barmer, Monica Craig, Shirley Hudson, Ankita Gupta
Journal: Cancer Research (2025)

Background: Respiratory syncytial virus (RSV) is one of the leading causes of respiratory infections, particularly in immunocompromised older adults. The recently available RSV vaccines offer a tool to reduce the disease burden. However, despite the availability of effective vaccines, vaccine fatigue, a phenomenon characterized by declining enthusiasm and adherence to vaccination campaigns due to the perceived overload of immunization schedules, has emerged as a challenge for vaccine uptake. With the increasing number of recommended vaccines, particularly in the wake of COVID-19 and the influenza vaccination efforts, many patients may experience hesitation toward additional vaccines, including RSV. This quality improvement study aims to explore the prevalence of vaccine fatigue and its effects on the uptake of the RSV vaccine among ArkLATX veterans to identify potential strategies to address this growing concern. Methods: Between 2023-2024, age-appropriate veterans from 3 Hematology-Oncology clinics at Overton Brooks VAMC were provided the CDC RSV vaccine pamphlet to read along with a provider discussion about the need, indication, and side effects. Afterward, the patients were offered the RSV vaccine. If they declined, they were asked about the reasons. Descriptive statistics, as well as the Chi-square test and logistic regression, were calculated to determine the impact of demographic factors on RSV vaccine uptake. Results: The sample consisted of 200 veterans from Arkansas, Louisiana, and Texas. The median age was 74, with an age range of 54-93 years. Participants were 93% male, 53% White, 45% Black, and 2% Other. Ninety-one percent were COVID19 vaccinated with 62% receiving both. Thirty-seven percent of the participants declined the RSV vaccine (factoring in 4% RSV vaccine uptake conversion rate during the study period), and 7% received neither. The main reasons for declining were “did not want another shot” (53%), current illness/vaccine reactions (11%), and unknown reasons (36%). There were no statistical differences with respect to age, sex, race, or geography between those who received the RSV vaccine and those who declined. Those who were COVID-19 vaccinated were more likely to have received the RSV vaccine (Odds Ratio=2.4, p=0.02). Conclusions: Our study reveals that the majority of ArkLATX veterans with cancer are willing to be vaccinated against RSV, though at a lesser rate than previously reported for the same group with the COVID-19 vaccine. The primary reason behind vaccine hesitancy was not wanting another vaccine injected, which was consistent with vaccine fatigue. Fortunately, no one voiced major concerns regarding vaccine safety or efficacy. The results suggest that targeted communication, consistent but not obtrusive reminders, simplifying access, and respecting the patient’s timing and mental readiness could improve uptake. Citation Format: Philip A. Haddad, Crystal Barmer, Monica Craig, Shirley Hudson, Ankita Gupta. RSV vaccine hesitancy among southern rural veterans with cancer in the Arkansas-Louisiana-Texas (ArkLATX) region: The impact of vaccine fatigue [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 807.