Influence of provider recommendations to restart vaccines after childhood cancer on caregiver intention to vaccinate

Abstract

Purpose We studied the influence of oncology and primary care provider (PCP) recommendations on caregiver intentions to restart vaccines (e.g., catch-up or boosters) after cancer treatment. Methods We surveyed primary caregivers ages 18 or older with a child who had completed cancer treatment 3-36 months prior (N= 145) about demographics, child's vaccination status, and healthcare factors (e.g., provider recommendations, barriers, preferences for vaccination). We compared these factors by caregiver's intention to restart vaccines ("vaccine intention" vs. "no intent to vaccinate") using bivariate and multivariable analyses. Results Caregivers were primarily ages 30-39 years (54.9%), mothers (80.6%), college graduates (44.4%), non-Hispanic (89.2%), and married (88.2%). Overall, 34.5% of caregivers did not know which vaccines their child needed. However, 65.5% of caregivers reported vaccine intention. Fewer caregivers with no intention to vaccinate believed that vaccinating their child helps protect others (85.4 vs. 99.0%,p< 0.01), that vaccines are needed when diseases are rare (83.7 vs. 100.0%,p< 0.01), and that vaccines are safe (80.4 vs. 92.6%,p= 0.03) and effective (91.5 vs. 98.9%,p= 0.04) compared with vaccine intention caregivers, respectively. Provider recommendations increased caregivers' likelihood of vaccine intention (oncologist RR = 1.65, 95% CI 1.27-2.12,p< 0.01; PCP RR = 1.51, 95% CI 1.19-1.94,p< 0.01). Conclusions Provider recommendations positively influence caregivers' intention to restart vaccines after childhood cancer. Guidelines are needed to support providers in making tailored vaccine recommendations. Implications for Cancer Survivors Timely vaccination after childhood cancer protects patients against vaccine-preventable diseases during survivorship. Caregivers may benefit from discussing restarting vaccinations after cancer with healthcare providers.