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New Survey Reveals Hesitancy Around COVID-19 Vaccination Among Patients With Hematologic Malignancies and Survivors


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A survey of more than 6,500 U.S. patients with blood cancer and survivors revealed that only half are very likely to get a COVID-19 vaccine, while one in three is either unlikely or unsure about it. The nationwide survey was a collaboration between The Leukemia & Lymphoma Society (LLS), Boston University Questrom School of Business and The Behaviouralist, a London-based research consultancy.

Patients with blood cancer have serious risk associated with COVID-19 infection. Some early studies suggest around half of patients with blood cancer hospitalized with COVID-19 will die from the disease.

“These findings are worrisome, to say the least,” said Gwen Nichols, MD, Chief Medical Officer of LLS. “We know patients with cancer—and patients with blood cancer, in particular—are susceptible to the worst effects of this virus. All of us in the medical community need to help patients understand the importance of getting vaccinated.”

Gwen Nichols, MD

Gwen Nichols, MD

“Patients with blood cancer are being given preferential access to limited vaccine supplies in many communities, but that doesn’t mean they are willing and able to get vaccinated,” said Rena Conti, PhD, Dean’s Research Scholar and Associate Professor at Boston University Questrom School of Business. “We need both adequate supply and strong demand to keep this vulnerable population safe.”

About the Survey

Patients and survivors included in LLS’s database were surveyed during the first 3 weeks of December 2020. During that time, the U.S. Food and Drug Administration granted Emergency Use Authorization to both the Moderna and Pfizer–BioNTech COVID-19 vaccines.

About 6 in 10 (59.8%) of the 6,516 respondents were female; 86% identified as White, 6.5% as Black or African American, and 4.7% as Hispanic or Latino/a. The average age of the respondents was 64 years, and most (70%) had an associate’s degree or more.

Seventy percent of respondents said they are either very likely (50%) or likely (20%) to get the COVID-19 vaccine. The remaining 30% said they are very unlikely (8%), unlikely (9%), or neither likely nor unlikely to get vaccinated (13%).

Vaccine Hesitancy

The survey is the largest to date asking patients with cancer and survivors about their attitudes towards COVID-19 vaccines. There have been widespread reports that patients with cancer and survivors across the country have struggled to obtain the vaccine. The newly released survey results add another wrinkle to that story: a large portion of patients with cancer may not feel comfortable getting the vaccine, even if it’s made available to them.

The most common reasons cited for hesitancy were concerns about side effects and a belief that the vaccines have not been tested properly. There is no reason to believe COVID-19 vaccines are any less safe in patients with blood cancers. There are concerns, however, that patients with some types of blood cancer or who are undergoing certain treatments may not mount the same immune response from the vaccine as the general public. Patients with cancer were largely excluded from COVID-19 vaccine trials.

LLS has launched the LLS National Patient Registry, open to anyone with blood cancer, to help answer important questions about vaccine effectiveness.

“Right now, we’re missing key data—and patients know it,” said Dr. Nichols. “That may be one of the reasons they’re skeptical. By improving our understanding of how patients with blood cancer and survivors respond to these vaccines, we can develop better strategies to protect them from COVID-19.”

LLS also plans to repeat the survey soon to assess patients’ and survivors’ evolving access to vaccines and willingness to get vaccinated. This effort will help improve future educational and outreach efforts to this vulnerable community.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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