Abstract:

Background: COVID-19 vaccination campaigns have reduced diseases severity and fatalities around the globe. However, Sub-Saharan Africa faces vaccine uptake challenges. Global data shows 67.7% of the general population are vaccinated, and Tanzania is reported appealing findings on the targeted vaccinating coverage (over 70%) among individuals aged 18 years and above by December 2022. However, a more specific assessment of the vaccination coverage by groups is needed, and cancer patients are priority group owing to their vulnerability.

Study objective: The study aimed at determining the uptake of COVID-19 vaccination and the factors associated to it among individuals receiving oncology services at the Ocean Road Cancer Institute (ORCI) facility in Dar as salaam, Tanzania

Methods: A convergent cross-sectional mixed method parallel study design was conducted incorporating both qualitative and quantitative research components. A stratified sampling was used for quantitative, and convenience sampling was applied for qualitative data collection. Quantitative data were collected through a mobile application, Open Data Kit (ODK) and analysed using the statistical software ‘R’. Qualitative data were collected through in-depth interviews analysed by R using a Structural Topic Modelling (STM) package. A total of 505 cancer patients participated in the study, with 479 in quantitative and 26 in qualitative. Univariate and multivariate logistic regression analyses were performed to determine significant associations between sociodemographic, clinical and health belief model (HBM) variables and COVID-19 vaccine among cancer patients. A thematic qualitative was conducted to explore the underlying beliefs and perceptions influencing vaccination decision. A triangulation of both findings was done to compare and contrast the results.

Results: A total of 384 (80.2%) of the interviewed participants in quantitative were female. The mean age for participants were 48 (± SD 12.4) years; ranging from 18 to 83 years. Approximately 58.0% (278/479) of the participants reported to be vaccinated against COVID-19, and among them 79.5% were females. Three factors showed significant associations with vaccine uptake; secondary education and above (OR 2.49, CI 1.50 – 4.18, p<0.001), perception on COVID-19 vaccine (OR 8.86, CI 2.84–32.2, p<0.001) and perceived severity of COVID-19 (OR 0.56, CI 0.36-0.87, p=0.010). In the qualitative part, 26 (73.1% female) participants participated in the study. The emerged themes during interviews included perceptions on the COVID-19 vaccine, motivating factors for vaccination among cancer patients, trust in information sources, and the influence of key figures. These themes collectively indicate the significant role of individuals beliefs, perceptions, and external factors in shaping decisions around COVID-10 vaccination.

Conclusion: Approximately 6 out of 10 cancer patients at the ORCI reported to be vaccinated; with patients care setting, perception on COVID-19 vaccine, and perceived severity being significantly associated with COVID-19 vaccination uptake. Public health interventions should leverage these identified factors to promote enhanced vaccine acceptance and uptake, through recognizing and tailoring communication efforts to specific characteristics.

Keywords: COVID-19 vaccine, Cancer patient, Oncology Services, Ocean Road Cancer institute