Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Barriers and enablers to vaccination among patients with haematological malignancies: A mixed-methods study informing service delivery models (126244)

Holly Chung 1 2 , Mei Krishnasamy 1 2 3 , Trish Joyce 4 , Tracey Dryden 4 , Ashley Whitechurch 4 , Paul Baden 5 , Simon Harrison 4 6 7 , Benjamin W Teh 6 8
  1. Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  2. Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
  3. Victorian Comprehensive Cancer Centre Alliance, Melbourne, Victoria, Australia
  4. Clinical Haematology, Peter MacCallum Cancer Centre and the Royal Melbourne Hospital, Melbourne, Victoria, Australia
  5. Royal Melbourne Hospital, Melbourne, Victoria
  6. Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  7. VCCC Alliance, Melbourne, Victoria, Australia
  8. Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria

Objectives/purpose

People affected by haematological malignancies face higher risk of morbidity and mortality from vaccine-preventable infections. However, completion rates of post-treatment immunisations are sub-optimal. Informing service innovation according to the needs and preferences of the target population may improve vaccine uptake. This study aimed to understand barriers, enablers and preferences to vaccination and novel vaccines among this special risk group.

Sample and setting

A two-stage mixed methods study in Australia. A purposive sample of Twenty patients with haematological malignancies who had received treatment within the previous two years participated in interviews. Seventy-eight patients responded to a national, cross-sectional survey.

Procedures

Exploratory semi-structured interviews were conducted and transcribed verbatim. Template analysis was used to develop a coding framework which was then mapped to the COM-B model of behaviour change to identify barriers and enablers. Subsequently, a survey was developed from interview results and disseminated online. Data were analysed using descriptive statistics for quantitative responses and content analysis for open-ended survey responses.

Results

Interviews found that while patients had good understanding of vaccination benefits, substantial barriers existed relating to opportunity (including care coordination, travel, time, and financial costs) and motivation (including concerns regarding intervention fatigue, potential side effects, and vaccine development processes, particularly mRNA technologies). Enablers included personalised information, automated care, and hybrid care models. Survey responses confirmed financial costs were common barriers (34% of respondents), with motivational concerns regarding side effects (53%) and reduced vaccine effectiveness (49%) being common. Patients valued shared care models but considered remaining linked to specialist care crucial.

Conclusion and clinical implications

Novel evidence demonstrates that patients with haematological malignancies face complex barriers to vaccination despite understanding benefits. Findings provide considerations to inform development of more acceptable, accessible, and appropriate vaccination delivery models, particularly hybrid and shared care approaches that maintain specialist oversight while addressing practical barriers.