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. 2021 Aug:153:260-264.
doi: 10.1016/j.ejca.2021.05.006. Epub 2021 May 26.

The first report on coronavirus disease 2019 (COVID-19) vaccine refusal by patients with solid cancer in Italy: Early data from a single-institute survey

Vincenzo Di Noia  1 , Davide Renna  2 , Vittoria Barberi  3 , Mattia Di Civita  4 , Federica Riva  5 , Giulia Costantini  6 , Emanuela Dell' Aquila  7 , Michelangelo Russillo  8 , Domenico Bracco  9 , Antonia Marina La Malfa  10 , Diana Giannarelli  11 , Francesco Cognetti  12
Affiliations

The first report on coronavirus disease 2019 (COVID-19) vaccine refusal by patients with solid cancer in Italy: Early data from a single-institute survey

Vincenzo Di Noia et al. Eur J Cancer. 2021 Aug.

Abstract

Introduction: Patients with cancer have an increased risk of complications from coronavirus disease 2019 (COVID-19) infection, including death, and thus, they were considered as high-priority subjects for COVID-19 vaccination. We report on the compliance with the COVID-19 vaccine of patients affected by solid tumours.

Materials and methods: Patients with cancer afferent to Medical Oncology 1 Unit of Regina Elena National Cancer Institute in Rome were considered eligible for vaccination if they were receiving systemic immunosuppressive antitumor treatment or received it in the last 6 months or having an uncontrolled advanced disease. The Pfizer BNT162b2 vaccine was proposed to all candidates via phone or during a scheduled visit. The reasons for refusal were collected by administrating a 6-item multiple-choice questionnaire.

Results: From 1st March to 20th March 2021, of 914 eligible patients, 102 refused vaccination (11.2%, 95% confidence interval [CI] 9.1-13.2). The most frequent (>10%) reasons reported were concerns about vaccine-related adverse events (48.1%), negative interaction with concomitant antitumor therapy (26.7%), and the fear of allergic reaction (10.7%). The refusal rate (RR) after 15th March (date of AstraZeneca-AZD1222 suspension) was more than doubled compared with the RR observed before (19.7% versus 8.6%, odds ratio [OR] 2.60, 95% CI 1.69-3.99; P < 0.0001). ECOG-PS 2 was associated with higher RR compared with ECOG-PS 0-1 (OR 2.94, 95% CI 1.04-8.34; P = 0.04). No statistically significant differences in RR according to other clinical characteristics were found.

Conclusions: Our experience represents the first worldwide report on the adherence of patients with cancer to COVID-19 vaccination and underlines how regulatory decisions and media news spreading could influence the success of the campaign.

Keywords: BNT162b2; COVID-19; Cancer patients; Public health; Refusal; SARS-CoV-2; Vaccine.

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Conflict of interest statement

Conflict of interest statement V.D.N. received speaker’s fee by AstraZeneca, MSD, BMS, Istituto Gentili, Boehringer Ingelheim. V.D.N. received grant consultancies by AstraZeneca, MSD, BMS, Boehringer Ingelheim and travel fee from MSD and Boehringer Ingelheim. V.D.N. received institutional research grants from Roche. F.C. was a member of advisory board of GSK, Roche, AstraZeneca, and Eli-Lilly. F.C. received speaker’s fee by GSK, Roche, AstraZeneca, Eli-Lilly, Novartis, Amgen, Pfizer, MSD, BMS, Astellas, and Eli-Lilly. All remaining authors have declared no conflicts of interest.

Figures

Fig.
Fig. 1
(A) Reasons reported by patients with cancer who refused COVID-19 vaccination in the questionnaire ∗.Others are self-reported reasons by patients (data not shown). (B) Refusal rate of COVID-19 vaccination in patients with cancer observed between 1st March and 14th March, 15th March and 20th March, and 1st March and 20th March. COVID-19, coronavirus disease 2019. No, number; Pts, Patients
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References

    1. Kuderer N.M., Choueiri T.K., Shah D.P., et al. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020;395:1907–1918. - PMC - PubMed
    1. Agenzia Italiana del Farmaco. COVID-19 vaccines communications. https://www.aifa.gov.it/en/web/guest/-/covid-19-vaccine-astrazeneca-bene.... Accessed April 15th, 2021.
    1. Barrière J., Gal J., Hoch B., et al. Acceptance of SARS-CoV-2 vaccination among French patients with cancer: a cross-sectional survey. Ann Oncol. 2021;32 773-674. - PMC - PubMed
    1. Open Online. Quanti sono i medici e infermieri No Vax negli ospedali? 35 mila non risultano ancora vaccinati: cosa non torna nelle stime basse dei sindacati https://www.open.online/2021/03/27/covid-19-medici-infermieri-no-vax-cos.... Accessed April 15th, 2021.
    1. Corriere della Sera. Vaccini, il sondaggio di Pagnoncelli: italiani ora più cauti, ma il 52% è pronto a farlo subito https://www.corriere.it/politica/21_marzo_20/vaccini-italiani-ora-piu-ca.... Accessed April 15th, 2021.

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