Global caregiver concerns of SARS-CoV-2 vaccination in children with cancer: a cross-sectional mixed-methods study

Abstract

The objective of this study was to understand global caregiver concerns about SARS-CoV-2 vaccination for children with cancer and to provide healthcare providers with guidance to support parental decision-making. A co-designed cross-sectional mixed-methods survey was distributed to primary caregivers of children with cancer globally between April and May 2021 via several media. Caregivers were asked to rate the importance of vaccine-related questions and the median scores were ranked. Principal Component Analysis was conducted to identify underlying dimensions of caregiver concerns by World Bank income groups. Content analysis of free-text responses was conducted and triangulated with the quantitative findings. 627 caregivers from 22 countries responded to the survey with 5.3% (n = 67) responses from low-and-middle-income countries (LMIC). 184 caregivers (29%) provided free-text responses. Side effects and vaccine safety were caregivers’ primary concerns in all countries. Questions related to logistics were of concern for caregivers in LMIC. A small minority of caregivers (n = 17) did not consider the survey questions important; free-text analysis identified these parents as vaccine hesitant, some of them quoting safety and side effects as main reasons for hesitancy. Healthcare providers and other community organizations globally need to provide tailored information about vaccine safety and effectiveness in pediatric oncology settings. Importantly, continued efforts are imperative to reduce global inequities in logistical access to vaccines, particularly in LMIC.

Keywords:

• Global child health
• immunization
• pediatric oncology
• SARS-CoV-2
• vaccine

Acknowledgements

Members of the COVID-19 vaccine global parent/carer advisory group as below contributed to the concept for this study and to the evaluation of its findings:

• Brian Regan, United States, Dana Farber/Boston Children’s Pediatric Patient/Family Advisory Committee

• Meghan Shea, United States, Dana Farber/Boston Children’s Pediatric Patient/Family Advisory Committee

• Julie Chessell, Canada, AC20RN

• Kim Buff, United States, Momcology

• Carmen Auste, Philippines, Childhood Cancer International

• Pinta Manullang-Panggabean, Indonesia, Yayasan Anyo Indonesia

• Poonam Bagai, India, Can Kids India

• John Ahenkorah, Ghana, Ghana Parents Group

We thank Dr José Luis Copado (Paediatric Infectious Diseases Specialist, Mexico) for translating the survey into Spanish.

We thank Professor Carlos Rodriguez-Galindo, for the support of the St Jude Global Alliance programme.

We would like to thank the caregivers for taking their time to participate in our survey and for sharing their views on the COVID-19 vaccine. We would also like to thank all those who helped to disseminate the survey globally.

Declaration of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Contributorship statement

JB had the concept for the study and led the co-design with KPJ and MC. JG, EK and JB developed the methodology. MH provided project administration and resources. JG and AS undertook the formal analysis and investigation of data. JG wrote the original draft of the paper supervised by JB. All authors revised the paper critically and approved the final version.

Data availability statement

The data that support the findings of the study are available on reasonable request from the corresponding author.

Additional information

Funding

This study was supported by ALSAC/St. Jude.