Post COVID19 vaccination burnout?: Providers’ perspectives on patients with lung cancer.

Abstract

401 Background: Patients with solid cancers undergoing chemotherapy or immunotherapy face increased risk of infections due to their immunosuppression and are recommended to undergo routine vaccination. However, despite increased attention to vaccination with the COVID19 pandemic, vaccination rates remain suboptimal among patients with cancer. Methods: Retrospective chart review was used to determine baseline rates of COVID19, Influenza, and Pneumococcal vaccination among a cohort of newly diagnosed patients with lung cancer at multi-site academic cancer center from 2018-2022 (n = 624). An anonymous survey was distributed to all Hematology-Oncology providers (n = 101) at the same institution with questions on current practice on accessing vaccination records and barriers to vaccinating patients starting chemotherapy and/or immunotherapy. Results: The baseline documented COVID-19 vaccination rate was 29.6%, while the baseline documented influenza and pneumococcal vaccination rates were 27.2% and 1.42%, respectively. Survey response was 32.7% (n = 33). Respondents were 60.0% Female (n = 15), 52.0% 30 - 39 years old (n = 13), 56.0% Attending Physicians (n = 14), 28.0% Fellow Physicians (n = 7), and 16.0% Nurse Practitioners (n = 4). 54.5% and 57.6% of respondents always recommended or discussed COVID19 and influenza vaccination, respectively, with their patients on chemotherapy or immunotherapy regardless of cancer type. 12.1% of respondents always recommended pneumococcal vaccination with their patients. The most common moderate barriers to COVID19 and influenza vaccination were “not having enough time” (COVID19, n = 12, 40.0%), (Influenza, n = 7, 26.9%), and “forgetting to bring up vaccines during the visit” (COVID19, n = 12, 40.0%), (Influenza, n = 9, 34.9%). “Not knowing when to administer the vaccine” was a moderate barrier to pneumococcal vaccination in 53.8% of respondents (n = 14). The most common preferred method for obtaining vaccination record information was through patient interview (n = 14, 63.6%). Similar trends were noted when limited to providers who cared for patients with lung cancer. Conclusions: Patients with lung cancer at this academic medical center were found to have low documented rates for COVID19, influenza, and pneumococcal vaccination. Common barriers in vaccination included lack of time and forgetting to bring up vaccination, but lack of knowledge of vaccination timing was only a significant barrier for pneumococcal vaccination. Improvement initiatives to address these identified factors are forthcoming.