Abstract
BACKGROUND: The COVID-19 pandemic has disproportionately affected individuals with cancer, who face heightened risks and complications. While vaccination emerged as a crucial strategy to control the pandemic, concerns about vaccine safety and efficacy have contributed to vaccine hesitancy. Despite existing research, there remains a gap in understanding the attitudes of patients with cancer toward COVID-19 vaccination in multicultural, middle-income settings. This qualitative study, conducted in Malaysia, explored these attitudes, shedding light on the factors influencing vaccine acceptance within this population to inform culturally appropriate interventions. METHODS: The participants were selected from the larger prospective study, Immune Responses and Wellbeing Following COVID-19 Vaccination in People With Cancer in Malaysia (iRESPOND@MY). A total of 12 semi-structured interviews were conducted with patients with cancer who expressed either low or high intention to receive the COVID-19 vaccine. The interviews were recorded, transcribed verbatim, and analysed thematically using NVivo V.12. RESULTS: Cancer patients' attitudes towards the COVID-19 vaccination can be categorised into two primary themes. The first is a positive attitude, which encompasses perceived benefits (believing the vaccine is safe and effective), perceived vulnerability (living as a cancer patient), and cues to action (such as following government mandates and practising preventive behaviour). The second is a negative attitude, which includes perceived barriers (belief in personal immunity, fear driven by media, lack of vaccine information, and uncertainty about the vaccine. These negative attitudes were influenced by conspiracy theories, such as scepticism about vaccine development and efficacy. CONCLUSION: This study underscores the need for tailored vaccination education for cancer patients, highlighting the importance of addressing misinformation and fears to improve vaccine uptake. These findings can guide future strategies to enhance vaccine acceptance in this vulnerable population.