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Xie Z, Lau JTF, Liang Y, Ouyang Q, Chen J, Lin S, Yao K, Hu X, Lin H, Yu Y, Zeng D. Prevalence and factors of COVID-19 vaccine refusal among solid cancer patients in China: an application of the health belief model. Front Public Health 2023; 11:1236376. [PMID: 37601174 PMCID: PMC10435902 DOI: 10.3389/fpubh.2023.1236376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction It is essential to protect cancer patients from contracting COVID-19 through vaccination. A majority of cancer patients are recommended by international health authorities to take up the vaccines. COVID-19 vaccine refusal among cancer patients during the pandemic period is under-researched. This study investigated factors of vaccine refusal based on the Health Belief Model (HBM). Methods A cross-sectional study was conducted among female breast cancer patients, male/female thyroid cancer patients, and gynecological cancer patients in Shantou, China from April to August 2022 (n = 1,115). Multinomial logistic regression analysis adjusted for socio-demographics was conducted to test factors of COVID-19. Adjusted odds ratios of the two models comparing vaccine refusal vs. "vaccine non-refusal" and vaccine refusal vs. ever-vaccination were derived and presented. Results Of all the participants, the prevalence of vaccine refusal, "vaccine non-refusal," and ever-vaccination was 25.9, 22.2, and 51.8%, respectively. In both multinomial logistic regression models, significant factors of vaccine refusal included socio-demographics (age, education level, employment status, monthly household income, cancer type, duration since cancer diagnosis, current treatment status) and some vaccine-related HBM (perceived benefits, perceived barriers, cue to action, and self-efficacy). Perceived severity of COVID-19 was significant only in the vaccine refusal vs. ever-vaccination model. In neither model, perceived susceptibility to contract COVID-19 was statistically significant. Conclusion About ¼ of the participants expressed vaccine refusal. Interventions are warranted. Future longitudinal studies are needed to verify this study's findings. Pilot interventions should also be launched to test effectiveness of interventions modifying the significant HBM factors found in this study.
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Affiliation(s)
- Zhaomin Xie
- School of Public Health, Shantou University, Shantou, China
- Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Joseph Tak-Fai Lau
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
- School of Public Health, Zhejiang University, Hangzhou, China
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuanke Liang
- Department of Thyroid and Breast Surgery, Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College (SUMC), Shantou, China
| | | | - Junjia Chen
- Shantou University Medical College, Shantou, China
| | - Si Lin
- Shantou University Medical College, Shantou, China
| | - Kaitao Yao
- Shantou University Medical College, Shantou, China
| | - Xuanyin Hu
- Shantou University Medical College, Shantou, China
| | - Haoyu Lin
- Department of Thyroid and Breast Surgery, Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College (SUMC), Shantou, China
| | - Yanqiu Yu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - De Zeng
- Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
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Affiliation(s)
- Eve Dubé
- Centre de recherche du CHU de Québec - Université Laval, Institut National de santé publique du Québec , Québec, Canada
| | - Noni E MacDonald
- Department of Pediatrics, Dalhousie University , Halifax, Canada
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