COVID-19 vaccination, infection, and symptoms among cancer survivors in the United States during 2021.

Abstract

e18786 Background: The effects of the COVID-19 pandemic on cancer survivorship during 2021, the second year in the US when vaccination became widely available, is largely undocumented. This study reports COVID-19 vaccination, infection, and symptoms among cancer survivors using nationally representative data. Methods: We used the 2021 National Health Interview Survey to identify adults with and without cancer history. Age-adjusted percentages for COVID-19 vaccinations, infection history and symptom severity were calculated among adults with and without a cancer history. We further calculated the percentage of COVID-related outcomes stratifying by sex, age, race/ethnicity, education level, and health insurance coverage among cancer survivors. Results: Compared to adults without a cancer history (n = 26,023), cancer survivors (n = 3,428) were more likely to have two or more COVID-19 vaccines (66.6% v 62.3%, P= 0.003) and as likely to have COVID-19 infection history (14.1% vs 14.2%, P= 0.93), but once infected, face higher likelihood of developing moderate/severe symptoms (62.5% v 54.2%, P= 0.02). Among cancer survivors, older age, higher educational attainment, and having health insurance coverage were significantly associated with higher vaccination rate (all P< 0.001). Age was significantly associated with COVID-19 infection history, with the highest percentage of COVID-19 infection history (17.3%) among cancer survivors aged 45-54 years. Among cancer survivors infected with COVID-19, being female and younger age were associated with higher likelihood of developing moderate to severe symptoms (both P< 0.05). Moreover, loss of taste or smell were most frequently seen among COVID-19 infected cancer survivors who were female (68.7%), 45-54 years of age (71.1%), Hispanic (73.2%), and survivors younger than 65 years without private insurance (75.1% for publicly insured and 73.1% for uninsured). Conclusions: In 2021, cancer survivors had better COVID-19 vaccine completion than adults without a cancer history. If infected, cancer survivors were more likely to develop moderate/severe symptoms; survivors who were female, younger age, Hispanic or uninsured had worse experiences with COVID-19 infection, suggesting ongoing tailored efforts to prevent infection are warranted as the pandemic evolves.