More than a third of adolescent and young adult (AYA) cancer survivors reported being hesitant about vaccination against COVID-19 in a survey conducted in Utah and surrounding Mountain West states. Despite the fact that COVID-19 vaccination provides protection to a population vulnerable to poor outcomes, 37.1% of AYA cancer survivors expressed vaccine hesitancy, according to researchers led by Austin Waters, MSPH, of Huntsman Cancer Institute at the University of Utah in Salt Lake City, and colleagues in JNCI Cancer Spectrum. However, the demographics of the surveyed population may explain the high degree of vaccine hesitation, Archie Bleyer, MD, of Oregon Health & Science University in Portland, told MedPage Today. "It's the region that really matters here," said Bleyer, who was not involved in the study. According to the study authors, adolescents and young adults have had the highest incidence of COVID-19 infection of any age group since June 2020. They noted that vaccine hesitancy is an issue in the American population in general, but is more problematic among cancer survivors who often have weakened immune systems and are more likely to develop severe respiratory infections. National organizations have recommended that cancer survivors receive the COVID-19 vaccine if they have no contraindications and that survivors on active treatment be a priority vaccination group. Thus, "identification of factors associated with vaccine hesitancy is an urgent priority for accelerating vaccination of this vulnerable population," Waters and team wrote. The survey was conducted among AYA cancer survivors ages 15 to 39 who received services through the Huntsman Intermountain Adolescent and Young Adult Cancer Care Program, with data collection occurring from October 2020 to January 2021. The 342 respondents completed a cross-sectional survey in which they indicated they strongly agreed or agreed with vaccination, or had a degree of vaccine hesitancy (strongly disagreed, disagreed, or neither disagreed or agreed with vaccination). The mean age of the respondents was 29.5 years; 61.1% were women and 81.3% were non-Hispanic white. More than half (55.3%) had received treatment since March 2020. Waters and colleagues found that female survivors had nearly two times higher odds of COVID-19 vaccine hesitancy (OR 1.81, 95% CI 1.10-2.98) versus male survivors. In addition, those with a high school education or less had 3.15 times higher odds (OR 3.15, 95% CI 1.41-7.04) of reporting vaccine hesitancy compared with college graduates. Bleyer noted that the higher levels of vaccine hesitancy among young female cancer survivors is not surprising considering the rumors that have circulated online suggesting the vaccine may affect fertility. Female cancer patients are already focused on this subject, considering the potential effect their cancer treatments can have on fertility, Bleyer pointed out. "That is a pretty obvious explanation why females are more likely to be concerned and hesitate." The authors acknowledged that their sample was collected across the Mountain West, and may not be generalizable to other regions. For example, they noted that they didn't collect information on political affiliation, which is known to be associated with vaccine hesitancy. In addition, "although reflective of the demographics of the region, our sample was homogenous precluding our ability to evaluate associations by race," they wrote. "The authors do say this has be interpreted carefully based on the region," Bleyer said. "But they don't emphasize that enough. This survey is highly dependent on the region." Specifically, Bleyer pointed out that the Mountain West is mostly white and Republican, "which is really important in analyzing these data." Source
