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Table of Contents
LETTER TO EDITOR
Year : 2021  |  Volume : 4  |  Issue : 3  |  Page : 567-568

The oncologist as COVID-19 vaccine teacher and logistician: A pathway to better outcomes


Department of Medicine, Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA

Date of Submission16-Aug-2021
Date of Acceptance29-Aug-2021
Date of Web Publication08-Oct-2021

Correspondence Address:
David A Potter
Department of Medicine, Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_194_21

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How to cite this article:
Potter DA. The oncologist as COVID-19 vaccine teacher and logistician: A pathway to better outcomes. Cancer Res Stat Treat 2021;4:567-8

How to cite this URL:
Potter DA. The oncologist as COVID-19 vaccine teacher and logistician: A pathway to better outcomes. Cancer Res Stat Treat [serial online] 2021 [cited 2021 Dec 9];4:567-8. Available from: https://www.crstonline.com/text.asp?2021/4/3/567/327783



COVID-19 vaccination hesitancy is a major problem worldwide[1],[2] and two recent articles highlight the extent of the vaccine hesitancy problem in solid tumor patients in India, while proposing potential solutions and illustrating the profound impact of vaccination. The lessons learned about COVID-19 vaccine hesitancy and potential solutions to this problem are of importance to cancer patients worldwide.

Noronha et al.[3] have performed a questionnaire-based study to evaluate the uptake of COVID-19 vaccination in Indian patients with solid tumors and identify the factors that promote vaccine hesitancy. In this large single institution study performed at a tertiary cancer hospital (435 patients), vaccine hesitancy was identified in 77% of patients. Fear was the most common reason for hesitancy, found in 38% of patients, the most common fears being the impact of vaccination on cancer treatment, fear of side effects of the vaccine, and fear of contracting COVID-19 from the vaccine. The second most prevalent cause of hesitancy was lack of vaccine information, found in 26.7% of patients. In the multivariate analysis, the factors found to be significantly associated with vaccine hesitancy were lower educational level (odds ratio [OR], 1.78; 95% confidence interval [CI], 1–3.17, P = 0.048) and lack of prior advice about COVID-19 vaccination (OR, 2.80; 95% CI, 1.73–4.53; P < 0.001). These results are of great importance and point toward the tremendous value of education in overcoming vaccine hesitancy. Most importantly, this instruction should come from the medical oncologists who are caring for patients with solid tumors, a patient group at higher risk for poor outcomes from COVID-19 infection.[4],[5] The integrating principle that we learn from this study is that while enormous effort is spent on improving cancer outcomes with ever improving treatments and clinical trials, the greatest impact may be achieved through patient education on vaccination. In this patient population, no one is more trusted by the patients than their oncologist who has built a therapeutic relationship for cancer care and it is this relationship that can overcome fear. It is notable that when patients were offered vaccination at the end of the questionnaire session, 91% of the patients said that they were willing. This is a remarkable result but also illustrates the importance of having the vaccine available in clinic so the teachable moment is not lost. Notably, 18.4% of patients reported that the vaccine was unavailable to them.

The accompanying paper by Batra et al.[6] is an observational study to gather information on the vaccination status of Indian patients with cancer. Conducted as a large single institution cross-sectional observational study of patients with solid tumors (752 patients), 29.1% of patients had received at least one dose of the COVID-19 vaccine. What is most striking about this study is that none of the vaccinated patients died due to COVID-19 while in the unvaccinated group, 11.9% died of COVID-19 or its complications.

Together, these studies support the prioritization of COVID-19 vaccine education in patients with cancer and provide real world data that support prior recommendations emphasizing the importance of vaccine education in patients with solid tumors.[7],[8] There are also logistical issues that need to be overcome bringing COVID-19 vaccines the “final mile” to our patients,[9] regardless of differences in details between countries. As oncologists we need to become better teachers and better logisticians in clinic. We cannot hand off a task that is this important.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Adhikari B, Cheah PY. Vaccine hesitancy in the COVID-19 era. Lancet Infect Dis 2021;21:1086.  Back to cited text no. 1
    
2.
Troiano G, Nardi A. Vaccine hesitancy in the era of COVID-19. Public Health 2021;194:245-51.  Back to cited text no. 2
    
3.
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.  Back to cited text no. 3
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4.
Izcovich A, Ragusa MA, Tortosa F, Lavena Marzio MA, Agnoletti C, Bengolea A, et al. Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review. PLoS One 2020;15:e0241955.  Back to cited text no. 4
    
5.
Ribas A, Sengupta R, Locke T, Zaidi SK, Campbell KM, Carethers JM, et al. Priority COVID-19 vaccination for patients with cancer while vaccine supply is limited. Cancer Discov 2021;11:233-6.  Back to cited text no. 5
    
6.
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.  Back to cited text no. 6
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7.
Swift MD, Sampathkumar P, Breeher LE, Ting HH, Virk A. Mayo clinic's multidisciplinary approach to Covid-19 vaccine allocation and distribution. NEJM Catalyst 2021;2:1-9.  Back to cited text no. 7
    
8.
Potter DA, Thomas A, Rugo HS. A neoadjuvant chemotherapy trial for early breast cancer is impacted by COVID-19: Addressing vaccination and cancer trials through education, equity, and outcomes. Clin Cancer Res 2021;27:4486-90.  Back to cited text no. 8
    
9.
Lee TH, Chen AH. Last-mile logistics of covid vaccination-The role of health care organizations. N Engl J Med 2021;384:685-7.  Back to cited text no. 9
    




 

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