Background
People affected by haematological malignancies (blood cancer) face higher risk of morbidity and mortality from vaccine-preventable diseases. However, post-treatment vaccination completion rates remain sub-optimal. Vaccine uptake could be improved through service innovation reflecting the needs and preferences of service-users. This study investigated barriers, enablers and preferences to vaccination and novel vaccines among this special risk group.
Methods
A two-stage mixed methods study in Australia. First, exploratory semi-structured interviews were undertaken with blood cancer patients. Inductive template analysis was used to develop codes, categories, themes; then the coding frame was mapped to the COM-B model of behaviour change and barriers and enablers identified. Then, a survey was developed from interview results and disseminated online to a national, cross-sectional, non-probabilistic sample of blood cancer patients who had received treatment. Data were analysed using descriptive statistics and qualitative content analysis as appropriate.
Results
Twenty people participated an interview, and 87 responded to the survey. Interviews found that while people had a good understanding of vaccination benefits, there were substantial barriers relating to opportunity (care coordination, travel, time, and financial costs) and motivation (concerns regarding intervention and appointment fatigue, potential side effects and injury, and distrust of vaccine development processes (particularly novel technologies such as mRNA)). Enablers identified included personalised information, automated care, and hybrid and shared care models. Survey responses confirmed that financial and economic costs of vaccinations were considerable barriers, and motivational concerns regarding fear of side effects and reduced immunogenicity were common. While people saw potential convenience benefits of shared care models, remaining linked into specialist care was crucial. Findings were synthesised to produce recommendations.
Conclusion
World first evidence investigating the people affected by haematological malignancies preferences regarding vaccination offer pragmatic recommendations to develop more acceptable, accessible, and appropriate models of vaccination delivery for blood cancer patients in Australia.