|LETTER TO EDITOR
|Year : 2021 | Volume
| Issue : 3 | Page : 564-565
We need to tackle vaccine hesitancy in our patients with cancer
Department of Infectious Diseases, Apollo Cancer Institute, Chennai, Tamil Nadu, India
|Date of Submission||28-Jul-2021|
|Date of Decision||01-Aug-2021|
|Date of Acceptance||06-Aug-2021|
|Date of Web Publication||10-Sep-2021|
Apollo Cancer Institute, 320 Anna Salai, Chennai - 600 035, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ghafur A. We need to tackle vaccine hesitancy in our patients with cancer. Cancer Res Stat Treat 2021;4:564-5
Oncology patients infected with COVID-19 have a high morbidity and mortality. The management of these patients poses a unique challenge compared to the non-oncology population. Discontinuation of isolation practices, therapeutics, the timing of further cancer care (chemotherapy, surgery, and stem cell transplant) after the recovery from COVID-19 infection are a few of the many challenges. The exclusion of oncology patients from major COVID-19 trials is one of the main reasons for the non-resolution of these issues, contrary to the situation in the general population where extensive data are now available. The situation holds good for the vaccination scenario in the oncology population. Lack of safety and efficacy data in this population makes the COVID-19 vaccine difficult for the patient with cancer to receive and even more difficult for the prescriber to recommend.
We want to highlight a few practical issues related to the COVID-19 vaccine in the oncology setting. First, there is a lack of safety and efficacy studies. Second, the optimal timing of vaccination is challenging in patients who are on active chemotherapy. Third, there is the possibility of inadequate efficacy of the vaccine in patients receiving long-acting immunotherapy. Finally, the two-dose schedule may not be adequate for this population. All these factors lead to vaccine hesitancy for both the prescriber and the patient.
Batra et al. and Noronha et al. have made excellent attempts to understand and estimate the vaccine hesitancy in oncology populations. Despite having the limitation of a retrospective observational cohort design, the study by Batra et al. revealed a significant reduction in the rate of hospitalization and mortality in the vaccinated oncology patients compared to the unvaccinated ones. This trend is very encouraging indeed. The study by Noronha et al. analyzed the reasons behind vaccine hesitancy. The fear of vaccination and the inadequate advice from the health-care providers were the main reasons for the vaccine hesitancy. Both these studies give us a good insight into the real-world scenario and persuade us to conduct further studies to resolve the caveats in the existing data in the oncology population. However, they do not attempt to answer the practical questions raised earlier. Noronha et al. have reported that most patients stated they were convinced of the importance of the vaccination by the end of the brief discussion with the physician administering the questionnaire. However, more than half of the patients also reported that they did not get advice from any health-care professional. This brings us to a significant point – the knowledge and attitude of the health-care professionals who take care of oncology patients regarding COVID-19 vaccination in oncology settings. These aspects can be easily studied through a questionnaire-based survey.
We can consider exploring the following options to improve vaccine uptake in the oncology population. First, we need to generate good quality data regarding the safety and efficacy data of various COVID-19 vaccines in this subset. Second, we need to educate health-care professionals such as doctors, physician assistants, nurses, and others, who take care of oncology patients on the importance of vaccination in this population. Third, as increasing numbers of immunocompromised patients get vaccinated, we should not miss the opportunity to study the safety, efficacy, and other vital parameters such as the timing of the vaccination in relation to chemotherapy. Finally, vaccination of the caretakers of close family members (ring vaccination) needs to be stressed. We do know that the vaccine may not result in the mounting of good immunity in our patients with cancer. Hence, vaccinating the family members will reduce the probability of the patients getting exposed to the virus.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Vijenthira A, Gong IY, Fox TA, Booth S, Cook G, Fattizzo B, et al
. Outcomes of patients with hematologic malignancies and COVID-19: A systematic review and meta-analysis of 3377 patients. Blood 2020;136:2881-92.
Bansal N, Ghafur A. COVID-19 in oncology settings. Cancer Res Stat Treat 2020;3:13-4. [Full text]
Voysey M, Clemens SA, Madhi SA, Weckx LY, Folegatti PM, Aley PK, et al.
Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: An interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet 2021;397:99-111.
Batra U, Nathany S, Bansal N, Sharma M. COVID-19 vaccination status in Indian patients with cancer: An observational study. Cancer Res Stat Treat 2021;4:219-23. [Full text]
Noronha V, Abraham G, Bondili SK, Rajpurohit A, Menon RP, Gattani S, et al.
COVID-19 vaccine uptake and vaccine hesitancy in Indian patients with cancer: A questionnaire-based survey. Cancer Res Stat Treat 2021;4:211-8. [Full text]