Adult Survivors of Childhood Cancer: Views on COVID-19 and Vaccination

PURPOSE/OBJECTIVE(S): Adult childhood cancer survivors (ACCS) are at increased risk of developing late effects because of their childhood cancer treatment, including cognitive delay, diabetes, metabolic syndrome, and organ damage. Consequently, many ACCS may be at increased risk for worse outcomes with COVID-19 infection. It is important to determine ACCS views on the COVID-19 pandemic and vaccination. MATERIALS/METHODS: A non-validated survey was created using multi-disciplinary input. Prior to the widespread rollout of COVID-19 vaccinations in Canada, we emailed an online survey to 235 ACCS followed through the BC Cancer Late Effects and Follow-Up clinic who had provided informed consent to email contact, receiving 89 responses (37.9% RR) which were analyzed. Statistical analysis was calculated using Chi-Squared test of association. RESULTS: Survey respondents were majority female (61%). The most common age range was 30-39 (30%) followed by 20-29 (28%). Most were of European descent (47%) and lived in an urban center (75%). The vast majority completed high school (97%), as well as post-secondary education (PSE, 73%). Only 29% did not use Complimentary or Alternative medicines (CAM), with herbal products being most common (48%), as well as massage therapy or other bodywork (46%). The most reported sources of health information were primary care practitioners (PCP, 80%), traditional media (60%), and specialized hospital clinics (46%). Of all respondents, 67% believed that ACCS should be prioritized for vaccination, with 87% indicating they would receive a COVID-19 vaccination if available. 78% and 89% believed that COVID-19 was a serious health problem for themselves or others, respectively. Views were evaluated across multiple subgroups. Respondents who had completed PSE were more likely to see COVID-19 as a risk to themselves (80% vs 71%, p = 0.358), to others (94% vs 75%, p = 0.012), and more likely to receive a vaccine (89% vs 79%, p=0.217). Respondents who received health information from traditional media felt COVID-19 was more likely to harm themselves (79% vs 75%, p=0.638), to harm others (93% vs 83%, p=0.181) and more likely to receive a vaccine (93% vs 78%, p=0.047). A similar trend was seen in those who receive information from a PCP, but without statistical significance. The opposite is true if health information is received from family or friends, with these respondents being less likely to feel COVID-19 poses a risk of harm to themselves (76% vs 78%, p=0.79), less likely to harm others (86% vs 90%, p=0.595), and a lower likelihood to get a vaccine (76% vs 92%, p=0.041). There was no discernable trend when examining by further subgroups, including CAM usage, age group, location, or other sources of health information. CONCLUSION: Many ACCS appear to underestimate their risk from COVID-19; whether patients had completed PSE and the location from which they receive health information appeared to correlate most strongly with these results.