Screening for Vaccination Status and Providing Appropriate COVID-19 Vaccine Education to Radiation Oncology Patients

Abstract

BackgroundPatients with cancer who are receiving Radiation Therapy (RT) are at an elevated risk of morbidity and mortality (M&M) from COVID-19 infection. Patients also may be unable to self-isolate, as they often require multiple hospital visits and close exposure to healthcare practitioners (HCPs). COVID-19 vaccination has been shown to mitigate risk of both COVID-19 infection and morbidity. It is important that patients undergoing RT or those recently diagnosed with cancer receive complete COVID-19 vaccination. Given their rapport with patients, HCPs are in a unique position to assess and treat the patient's cancer and engage in discussions regarding important health decisions. Our goal was to use the patient-provider relationship to identify reasons to forego vaccination, address specific concerns as a trusted source, and encourage COVID-19 vaccination for patients with cancer.MethodsWe identified and screened all new patients who were either unvaccinated or had undocumented COVID-19 vaccination status from 11/2021 to 2/2022. Instruction on reconciling vaccination status in EPIC was provided to HCPs. Weekly reports of unvaccinated patients were generated and distributed for upcoming consultations. HCPs were given vaccine education resources and instructed to document that education was delivered. Information regarding pre-simulation COVID-19 PCR testing, vaccine status, vaccine education, and reasons for not being vaccinated was collected.ResultsA total of 909 patients were seen in consultation from 11/1/2021 to 2/28/2022. Of these, 152 patients were unvaccinated/undocumented vaccination status, of which 147 (16.2%) were eligible for our vaccination education (1 declined prior to consultation, 3 pediatric, 1 patient with dementia excluded). 27 (18.4%) patients received vaccination education at time of consultation. Of these patients, 6 (22.2%) eligible patients who received vaccine education initiated the COVID-19 vaccination within 60 days of consultation. On pre-simulation COVID testing, 32 patients tested positive for COVID-19.DiscussionCOVID-19 infection has significant M&M and has serious implications for patients with cancer. We developed a COVID-19 vaccination initiative to identify and reconcile vaccination status and provide vaccine education to cancer patients. 27/147 (18.4%) eligible patients received vaccine education, of which 6 (22.2%) received partial or full vaccination. Despite educating clinicians and sending weekly reports, COVID-19 vaccine education to patients remained low, which may suggest there are several challenges for specialized HCPs in performing vaccine education despite its clear medical importance. As the outlook of COVID-19 continues to evolve, providing accurate information regarding the COVID-19 virus and vaccination is crucial for the well-being of cancer patients.