Refusal of vaccination against influenza and COVID-19 in patients with solid cancers: from bio-ethical issues to solutions
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée à la COVID-19
In 2022, Di Noia et al (1) and Gong et al (2) demonstrated a real benefit of full vaccination against COVID-19 in patients treated for solid cancers. However, refusal remains a persistent problem that cannot be ignored in this population. This phenomenon is not specific to COVID-19. In 2008, Loulergue et al reported a rate of anti-flu vaccination of only about 30%, despite the expected protective effects of such vaccination, in a single-center cohort of 122 patients treated for solid cancers in France (3). One of the principal reasons for refusing vaccination was doubts about its efficacy. In 2020, Monier et al also reported low rates of anti-flu vaccination (26.7%) among 439 French patients treated for solid tumors. They also found that patients not vaccinated against flu or other pathogenic agents tended to have a poor opinion of vaccination (4).
In 2022, we published the results of an interdisciplinary bioethics study on the refusal of cancer patients to accept vaccination against COVID-19. This study was performed on a single-center cohort of patients treated as outpatients for a solid cancer between April and November 2021 at Foch Hospital. The preliminary results, published in June 2021, indicated that the refusal rate was 5.6% (29/522), and that refusal rates were significantly higher for women than for men (p = 0.001)(5). The final results were published in August 2022, revealing vaccination policy to be a major bioethics issue, with obligatory vaccination as a satisfactory bio-ethical solution to this specific problem.
European Journal of Cancer , éditorial en libre accès, 2022