A new study led by Monash Health and Monash University researchers has uncovered  important insights to explain COVID19 vaccine hesitancy amongst people with solid cancers, and recommended practical solutions  to better inform and support patients.

Dr Nathan Bain and Dr Mike Nguyen co-led a recently published paper in online journal, Vaccines, that explored COVID-19 vaccine hesitancy in people with solid cancers from the CANcer patients’ perspectives on coronavirus VACCination Survey (CANVACCS) data. A total of 2691 people with solid organ cancers participated.

They found that vaccine attitudes and hesitancy in people with cancer are substantially influenced by their underlying cancer diagnosis.

Dr Bain explained; “Medical vulnerability to COVID-19 due to illness or being on anti-cancer treatments can motivate and enable positive vaccine uptake; however, it can also cause concerns regarding the potential negative impacts of the vaccine on their health, underlying cancer and treatments.” 

“These complex concerns must be addressed both in individual patients and in public health messaging to best protect this medically vulnerable population from the ongoing morbidity and mortality of the COVID-19 pandemic,” Dr Bain said.

The study identified the following five findings:

  1.  People who had been diagnosed with cancer for a longer period and people with genitourinary cancer were more likely to be vaccinated.
  2. People with head and neck cancer were less likely to be vaccinated.
  3. Vaccine hesitancy was higher in people who were younger, female, spoke English as a non-dominant language and lived in a regional location. 
  4. Prominent concerns identified including the impact of cancer on vaccine efficacy, adverse effects, and interactions with anti-cancer treatments. This was particularly strong amongst unvaccinated participants.
  5. Just over half of the participants (56.8%) were concerned that their cancer diagnosis increased their vulnerability to COVID-19 infection, regardless of their vaccination status.


Dr Mike Nguyen explained that these findings allowed them to explore ways in which we can better assist these patients in the future. 

“We asked, what can we learn from this research and how can we support these patients to make an informed decision?” said Dr Nguyen. 

“We came up with three practical solutions:

  1. Address cancer-related concerns about COVID-19 infection at both individual and population levels. 
  2. Trust healthcare professionals. They play a key-role in vaccination campaigns, especially with the need for booster doses.
  3. Use DIVAS-6. It is a quick and useful tool for healthcare professionals to facilitate individualised discussions with their patients.”

CANVACCS was conducted at nine Australian health services and collected sociodemographic and clinical characteristics, in addition to responses to three scales that assessed views and beliefs regarding COVID-19 vaccination: the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale, and the DIVAS-6.

This large collaborative study was led by Adjunct Professor at Monash University, Eva Segelov. The Monash study team also included Monash University Medicine senior research fellow Dr Lisa Grech and Monash Health medical oncologists Dr Daphne Day, Dr Amelia McCartney, and Dr Kate Webber. 

The study team are grateful for the contributions from consumer advisor Ms Janne Williams, participating patients and the CANVACCS investigators* at Monash Health, Bendigo Health, Latrobe Regional Hospital, Sunshine Coast Hospital and Health Service, Icon Cancer Centre Hobart, St Vincent’s Hospital Sydney, Campbelltown Hospital, and Border Medical Oncology.

*CANVACCS, CANcer patients’ perspectives on coronavirus VACCination Survey.

For more information please contact CANVACCS@monashhealth.org.