A survey on the attitude and willingness of Chinese cancer patients toward a COVID-19 booster vaccine

A survey on the attitude and willingness of Chinese cancer patients toward a COVID-19 booster vaccine | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A survey on the attitude and willingness of Chinese cancer patients toward a COVID-19 booster vaccine Man Yao, Peng Wang, Meng Wang, Sheng-qi Zheng, Xiao-wan Xu, Qing-mei Zhang, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4240784/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 01 Feb, 2024 Read the published version in Heliyon → Version 1 posted You are reading this latest preprint version Abstract Objective The 2019 novel coronavirus is still rapidly mutating and spreading worldwide, posing a great global health challenge, especially vulnerable groups, including cancer patients. Studies comparing the clinical outcomes of cancer patients receiving or not receiving the 2019 coronavirus disease (COVID-19) vaccines have not yet shown significant benefits. Therefore, this study mainly focused on the attitudes and willingness of cancer patients toward COVID-19 booster vaccines and to distinguish independent predictors that may impact the vaccination of cancer patients. Methods An online cross-sectional study was conducted between July 1 2022 and January 1 2023 in China. Patients were selected using a convenience sampling method, and a self-reporting questionnaire was developed based on a literature review to evaluate the attitude of cancer patients towards the intensive use of COVID-19 vaccines and the willingness of patients to accept the COVID-19 vaccine. Independent predictors associated with accepting a COVID-19 booster vaccine were determined through multivariate logistic regression. Results A total of 1055 participants were included in this study. The vaccine acceptance rate was 56.11% (592/1055), while the hesitancy rate was 43.89% (463/1055). Frequent smoking, those who had received two doses of the COVID-19 vaccine, belief that the COVID-19 booster vaccine was necessary, belief that the COVID-19 booster vaccine was safe and effective, willingness to pay for the COVID-19 booster vaccine, and recommendation of COVID-19 booster vaccine by friends and family were contributing factors for vaccine acceptance. Conclusion This study recommends developing healthcare policies appropriate for cancer patients to facilitate their acceptance of vaccines, such as publishing the safety and effectiveness of vaccines, providing individualized treatment options after adequate risk assessment and developing specific COVID-19 vaccines suitable for cancer patients. COVID-19 booster vaccine cancer patients cross-sectional study Attitude Vaccine Acceptance Figures Figure 1 1. Introduction The ongoing COVID-19 pandemic has imposed severe stress on economic recovery and development worldwide and has strained the already fragile medical and healthcare systems of some developing countries. More than 772 million confirmed COVID-19 cases and deaths were reported globally by November 22 2023, totaling more than 6.98 million cases [ 1 ]. As a vulnerable group, cancer patients are among the most affected individuals during public health crisis. Previous studies postulated that cancer patients who contract COVID-19 have higher risks of complications and exacerbated disease or even death [ 2 – 4 ]. Although active malignancy has been shown to be an independent risk factor in most studies, this increased risk may be attributed to the co-occurrence of risk factors associated with the general population [ 5 ]. In the first wave of the COVID-19 outbreak, there was an unusually high death rate among active cancer patients with COVID-19, reaching up to about 40%. However, the rate was reduced to about 25% in a subsequent wave in European countries in 2021. The incidence of long-term COVID-19 sequelae in cancer patients is estimated at 15–30% [ 6 ]. The first results of the European Society for Medical Oncology (ESMO) COVID-19 and CAncer REgistry (ESMO-CoCARE) revealed that patient/cancer characteristics related to gender, ethnicity, poor fitness, comorbidities, systemic inflammation, and the presence of an active malignancy were associated with moderate/severe disease and adverse outcomes from COVID-19 in cancer patients [ 7 ]. Vaccination is generally regarded as the most effective means of combating infectious diseases. Unfortunately, the few pivotal COVID-19 vaccine clinical trials have only included a small number of cancer patients [ 8 , 9 ], reducing the clarity of the potential risks of the vaccine in patients. This phenomenon has greatly affected the determination of cancer patients to be vaccinated. According to a survey conducted in Italy, only 11.2% of cancer patients were unwilling to receive the COVID-19 vaccine [ 10 ]. A cross-sectional analysis in Victoria, Australia, reported that 84% of respondents had a positive perception towards COVID-19 vaccination, 10% were undecided, and 6% had a negative perception towards vaccination. Amongst the respondents, the number of patients injected with one or more doses of vaccine reached 65%, and 35% were unvaccinated [ 11 ]. A survey in eastern China reported that the proportion of vaccination with COVID-19 vaccine among cancer patients reached 35.54%, and 40.01% of the patients were receptive to the vaccine, while 24.05% were skeptical about the COVID-19 vaccine [ 12 – 15 ]. Several countries are currently providing COVID-19 booster vaccines, which are defined as the third and above shots of the COVID-19 vaccine. Available data indicate that the COVID-19 booster vaccine significantly prolongs immune response during the omicron B.1.1.529 epidemic. Nonetheless, whether it is necessary for cancer patients in China to be injected with the COVID-19 booster vaccine still needs further verification [ 16 ]. Some medical experts are concerned that vaccination may overload the immune system and trigger a “cytokine storm,” resulting in severe toxicities that can damage organs and even lead to death. There are no direct answers to this question, but experts believe that cancer patients may benefit from COVID-19 vaccines based on data from other epidemic diseases [ 17 , 18 ]. This study aimed to determine the attitude and willingness of Chinese cancer patients toward the COVID-19 booster vaccines and to distinguish independent predictors that may impact the vaccination of cancer patients. 2. Materials/Methods 2.1 Study design and subjects The study employed a cross-sectional and anonymous design, which was conducted online in China for six months from July 1, 2022, and January 1, 2023. A self-reporting survey was sent to adult cancer patients through the “Wenjuanxing” online survey platform. Our team sent the questionnaire link of the "Wenjuanxing" platform to participants who have received anti-tumor treatment in the hospital or are receiving anti-tumor treatment in the hospital through wechat groups, websites, hospital posters, and other means. Participants clicked the link to start answering questions. Cancer patients with mental disabilities were excluded. Survey participation was voluntary and took about eight minutes to complete. There was no material reward for participation. The estimated sample size of this study was mainly based on the assumption that 61.1% of the participants were voluntarily vaccinated with COVID-19 vaccine [ 19 ]. The actual sample size was calculated as follows: \({\text{n = }}{{\text{Z}}^{\text{2}}}_{{{\text{1}}\,{\text{-}}\,{\text{\varvec{\alpha}/2}}}}P\left( {{\text{1 -}}P} \right){\text{/}}{{\text{e}}^{\text{2}}}\) Where n denotes the minimum sample size, Z 2 denotes the 95% confidence interval (CI)=(1.96) 2 , P denotes the previously estimated morbidity rate, and e denotes the error = 0.04. Given a non-response rate of 10%, the minimum sample size for this study was 628 participants. 2.2 Survey A self-reporting survey was developed based on a review of relevant studies [ 12 , 20 – 22 ]. The survey mainly evaluated the attitude and acceptance of patients toward the COVID-19 booster vaccine. The survey was designed in Chinese, translated into English, and then back to Chinese, followed by a series of validations before release. A small pilot survey comprising 50 cancer patients was first conducted to test the authenticity and validity of the survey and to identify any potential problems during data collection. In this pilot study, respondents were invited to complete the questionnaire, which took an average of 5 minutes. After completing the questionnaire, we interviewed each respondent and asked them about possible problems with the questionnaire. These interviews took an average of 9 minutes, and no problem was identified in this pilot survey. The response variable for this study was the acceptance of Chinese cancer patients to get a booster vaccine. We measured the temperature of the interviewees and inquired whether the patients wanted the COVID-19 booster vaccine. If the answer given by the patient after the inquiry was “Yes,” the questioner asked why the patient was receptive to the vaccine. If the answer after the above inquiry was “No,” the questioner asked why the respondents were reluctant to accept the vaccine. Several explanatory variables were also collected in this study, including the demographic data (The detailed questionnaire survey content is available at Supplement Table 1 .). The demographic data of the respondents mainly involves the following aspects: age, male/female, BMI, whether married or not, current residence address, education level, actual job category, total income for one month, and whether the respondents had smoking and drinking behaviors. The participants’ clinical characteristics included cancer category, time of cancer detection, any underlying disease, presence of complications, presence of metastasis, vaccination with 2 shots of the vaccine, and risk of COVID-19. The participant’s perception of the vaccine was determined based on these questions: Do you think a booster shot is necessary? Do you think the vaccine can increase side effects? Do you think people will get seriously ill even if they get infected after getting the booster vaccine? Do you think the vaccine can increase protection against COVID-19? Do you think the vaccine can provide protection against new variants? Do you think the vaccine provides persistent protection? Do you think the booster vaccine may impact cancer treatment? Do you think the booster vaccine is safe and effective? Are you willing to pay for the vaccine? Will you recommend the booster vaccine to your friends and family? The possible answers to these questions were “yes” or “no.” 2.3 Statistical analysis Questionnaires with missing data will be considered incomplete and will not be included in this study. Sociodemographic characteristics, clinical characteristics, and attitudes towards the vaccine of the participants were analyzed using descriptive statistics and expressed as percentages. All variables in this study are categorical variables, and the most answers are presented as "yes" and "no". In statistics, "no" is coded as 0, "yes" is coded as 1, and other answers are coded as 0–3 according to the degree of the event, for example, in "Risk of COVID-19 infection" group, "None" is coded as 0, "Low" is coded as 1, "Medium" is coded as 2, and "High" is coded as 3. The relationship between the independent variables (general participant information and perception of the COVID-19 booster vaccine) and the dependent variable (intention towards the COVID-19 booster vaccine) was assessed through a chi-squared test. Variables with a P -value < 0.05 in the univariate analyses were considered meaningful and were used in multivariate logistic regression analyses to identify independent predictors influencing the acceptance. The adjusted odds ratio (AOR) and 95% CI of these variables were then reported, which was mainly used to quantify the correlation strength between exposure factors and outcome events. If the obtained P -value was lower than 0.05, then the result was considered to have a statistical value. All the statistical analyses were conducted using SPSS 21.0 software (SPSS Inc., IL in Chicago, USA). 2.4 Ethics review and approval The study was approved by the Ethics Committee of the Chaohu Hospital of Anhui Medical University (KYXM-20210501) and the First Affiliated Hospital of Naval Medical University (CHEC2013-119). All respondents fully grasped the objectives and procedures of the study and signed an oral informed consent form. 3 Results 3.1 Characteristics and acceptance of participants towards the COVID-19 booster vaccine A total of 1122 participants took part in filling out the survey. Among them, 36 did not complete their sociodemographic information, and 31 completed the questionnaire in less than 2.5 minutes, a total of 1055 participants completed the questionnaire, bringing the overall response rate in this cross-sectional study to 94.11%. Among the 1055 participants, 592 indicated willingness towards receiving the COVID-19 booster vaccine (56.11% vaccine acceptance rate), while 463 indicated unwillingness towards receiving the COVID-19 booster vaccine (43.89% vaccine hesitancy rate) (Table 1 ). Of the 1055 participants, 58.58% were aged 40–60 years, 63.22%were males, 93.74% were married, 49.86% had an average monthly income of < 3000 CNY, 81.33% were non-smokers, and 73.85% had no family history of cancer. Most participants had no underlying conditions. Table 1 Demographic characteristics and clinical features of participants. Items under investigation All participants (N = 1055) Intention to use vaccine Hesitancy (N = 463) Acceptance (N = 592) P Age (Year) 0.694 60 330(31.38%) 148(31.97%) 182(30.74%) Gender 0.462 Female 388(36.78%) 176(38.01%) 212(35.81%) Male 667(63.22%) 287(61.99%) 380(64.19%) BMI (kg/m 2 ) 0.594 28 86(8.15%) 43(9.29%) 43(7.26%) Marital status 0.010 Unmarried 23(2.18%) 3(0.65%) 20(3.38%) Married 989(93.74%) 442(95.46%) 547(92.40%) Divorced/Widowed 43(4.08%) 18(3.89%) 25(4.22%) Residence < 0.001 Rural 351(33.27%) 124(26.78%) 227(38.34%) Urban 704(66.73%) 339(73.22%) 365(61.66%) Education level 0.603 ≤Senior high school 677(64.17%) 290(62.63%) 387(65.37%) College degree 188(17.82%) 88(19.01%) 100(17.82%) ≥Bachelor’s degree 190(18.01%) 85(18.36%) 190(18.01%) Occupation 0.059 Unemployed 318(30.14%) 130(28.08%) 188(31.76%) Employed 344(32.61%) 142(30.67%) 202(34.12%) Retired 392(37.25%) 191(41.25%) 202(34.12%0 Average monthly income (CNY) 0.524 8000 122(11.56%) 57(12.31%) 65(10.98%) Current smoking status 0.009 Never 858(81.33%) 395(85.31%) 463(78.21%) Occasionally 127(12.04%) 47(10.15%) 80(13.51%) Frequently 70(6.64%) 21(4.54%) 49(8.28%) Current drinking status < 0.001 Never 857(81.23%) 402(86.83%) 455(76.86%) Occasionally 168(15.92%) 52(11.23%) 116(19.59%) Frequently 30(2.84%) 9(1.94%) 21(3.55%) Cancer type < 0.001 Head and neck cancer 66(6.26%) 19(4.10%) 47(7.94%) Respiratory and thoracic cancer 194(18.39%) 70(15.12%) 124(20.95%) Digestive tract cancer 614(58.20%) 314(67.82%) 300(50.68%) Urogenital caner 24(2.27%) 8(1.73%) 16(2.70%) Gynecologic cancer 125(11.85%) 45(9.72%) 80(13.51%) Other cancer type 32(3.03%) 7(1.51%) 25(3.03%0 Time of cancer diagnosis 0.195 5 years 206(19.53%) 91(19.65%) 115(19.43%) Other underlying diseases 0.392 No 726(68.82%) 325(70.19%) 401(67.74%) Yes 329(31.18%) 138(29.81%) 191(32.26%) Family history of cancer 0.584 No 779(73.84%) 338(73.00%) 441(74.49%) Yes 276(26.16%) 125(27.00%) 151(25.51%) Complication 0.520 No 906(85.88%) 394(85.10%) 512(85.88%) Yes 149(14.12%) 69(14.90%) 80(13.51%) Metastasis 0.106 No 747(70.81%) 316(68.25%) 431(72.80%) Yes 308(29.19%) 147(31.75%) 161(27.20%) Do you accept two doses of COVID-19 vaccine? No 665(63.03%) 396(85.53%) 269(45.44%) < 0.001 Yes 390(36.97%) 67(14.47%) 323(54.56%) Risk of COVID-19 infection None 293(27.77%) 112(24.19%) 181(30.57%) 0.009 Low 480(45.50%) 232(50.11%) 248(41.89%) Medium 142(13.46%) 52(11.23%) 90(15.20%) High 140(13.27%) 67(14.47%) 73(12.33%) Participants were divided into two groups, the “Hesitancy” and “Acceptance” groups, and the P -values were obtained via a chi-squared test between the two groups. BMI: body mass index; CNY: Chinese yuan; COVID-19: Coronavirus Disease 2019. Sociodemographic characteristics showed that marital status, residence, current smoking status, and current drinking status, cancer type, and risk of COVID-19 infection were highly varied between the acceptance group and vaccine-hesitant group (all P < 0.05). The percentage of the participants who received two doses of COVID-19 vaccine shots also differed between the groups, with a P value less than 0.05. 3.2 Sources of material regarding the COVID-19 vaccine In the vaccine acceptance group, The government agencies was the largest source of the information from which most of the participants obtained information about COVID-19 booster vaccine, accounting for 61.31%, followed by media ( 363/592, 61.32%), friends and families (259/592, 43.75%), and others (82/592, 13.85%), while in the vaccine hesitancy group, the largest sources of information about the COVID-19 vaccine were media (223/463, 48.16%), followed by government agencies (179/463, 38.66%) and friends and families (152/463, 32.83%) (Fig. 1 ). 3.3 Participants’ attitudes towards the COVID-19 booster vaccine The attitudes towards the COVID-19 booster vaccine significantly differed between the acceptance group and vaccine-hesitant group ( P < 0.05 for all 10 questions) (Table 2 ). Over three-quarters of the patients (789/1055, 74.79%) believed that COVID-19 booster vaccine was necessary, while only about a quarter of the patients (290/1055, 27.49%) indicated that COVID-19 booster vaccine will cause side effects. In the same line, 65.50% (691/1055) of the patients supposed that they would not get seriously ill even if they get infected after getting the COVID-19 booster vaccine. Most patients believed that the COVID-19 booster vaccine could enhance protection against COVID-19 (926/1055, 87.77%), was protective against new variants (889/1055, 84.27%), and would provide persistent protection (739/1055, 70.05%). Over half of the patients (636/1055, 60.28%) thought that the COVID-19 booster vaccine could affect cancer treatment, while about half of the patients (522/1055, 49.48%) thought that the COVID-19 booster vaccine was safe and effective. Only 33.27% (351/1055) of patients were willing to pay for the COVID-19 booster vaccine. Among all patients, 90.14% (951/1055) of patients recommended COVID-19 booster vaccine to their friends and family. Table 2 Participants’ attitudes towards the COVID-19 booster vaccine. Items under investigation All participants (N = 1055) Intention Hesitancy (N = 463) Acceptance (N = 592) P Do you think it is necessary to accept COVID-19 booster vaccine? < 0.001 No 266(25.21%) 209(45.14%) 57(9.63%) Yes 789(74.79%) 254(54.86%) 535(90.37%) In general, do you think COVID-19 booster vaccine will cause side effects? < 0.001 No 765(72.51%) 279(60.26%) 486(82.09%) Yes 290(27.49%) 184(39.74%) 106(17.91%) Do you think you will get seriously ill even if they get infected after getting the COVID-19 booster vaccine? 0.034 No 364(34.50%) 176(38.01%) 188(31.76%) Yes 691(65.50%) 287(61.99%) 404(68.24%) Do you think the COVID-19 booster vaccine can increase protection against COVID-19? < 0.001 No 129(12.23%) 88(19.01%) 41(6.93%) Yes 926(87.77%) 375(80.99%) 551(93.07%) Do you think the COVID-19 booster vaccine can provide protection against new variants? < 0.001 No 166(15.73%) 98(21.17%) 68(11.49%) Yes 889(84.27%) 365(78.83%) 524(88.51%) Do you think the COVID-19 booster vaccine provides persistent protection? < 0.001 No 316(9.95%%) 185(39.96%) 131(22.13%) Yes 739(70.05%) 278(60.04%) 461(77.87%) Do you think the COVID-19 booster vaccination may impact cancer treatment? < 0.001 No 419(39.72%) 72(15.55%) 347(58.61%) Yes 636(60.28%) 391(84.45%) 245(41.39%) Do you think the COVID-19 booster vaccine is safe and effective? < 0.001 No 533(50.52%) 299(64.58%) 234(39.53%) Yes 522(49.48%) 164(35.42%) 358(60.43%) Are you willing to pay for the COVID-19 booster vaccine? < 0.001 No 704(66.73%) 340(73.43%) 364(61.49%) Yes 351(33.27%) 123(26.57%) 228(38.51%) Will you recommend the COVID-19 booster vaccine to your friends and family? < 0.001 No 104(9.86%) 80(17.28%) 24(4.05%) Yes 951(90.14%) 383(82.72%) 568(95.95%) The study participants were divided into “Hesitancy” and “Acceptance” groups for comparative analysis, and the P -values were calculated via a chi-squared test between the two groups. COVID-19: Coronavirus Disease 2019. 3.4 Independent predictors that impact COVID-19 booster vaccination Seventeen significant ( P < 0.05) variables were identified through univariate analysis. Multivariate logistic regression of the 17 variables revealed 9 variables that significantly impacted the participants’ willingness to get the COVID-19 booster vaccine ( P < 0.05) (Table 3 ). Table 4 shows the goodness of fit of the multivariate logistic regression model judged by the Hosmer-Lemeshow goodness of fit test. The model passed the Hosmer-Lemeshow goodness of fit test, and the goodness of fit of the model was good. Table 3 Independent predictors of intention to accept COVID-19 booster vaccine. Variables Intention to use vaccine OR (95% CI) P Hesitancy (N = 463) Acceptance (N = 592) Marital status Unmarried 3(0.65%) 20(3.38%) Ref / Married 442(95.46%) 547(92.40%) 0.684(0.149–3.148) 0.626 Divorced/Widowed 18(3.89%) 25(4.22%) 0.700(0.123–3.971) 0.687 Residence Rural 124(26.78%) 227(38.34%) Ref / Urban 339(73.22%) 365(61.66%) 0.651(0.456–0.930) 0.018 Current smoking status Never 395(85.31%) 463(78.21%) Ref / Occasionally 47(10.15%) 80(13.51%) 1.283(0.732–2.251) 0.384 Always 21(4.54%) 49(8.28%) 3.182(1.422–7.119) 0.005 Current drinking status Never 402(86.83%) 455(76.86%) Ref / Occasionally 52(11.23%) 116(19.59%) 1.320(0.793–2.197) 0.286 Always 9(1.94%) 21(3.55%) 1.468(0.447–4.819) 0.526 Type of cancer Head and neck cancer 19(4.10%) 47(7.94%) Ref / Respiratory and thoracic cancer 70(15.12%) 124(20.95%) 0.585(0.246–1.387) 0.223 Digestive tract cancer 314(67.82%) 300(50.68%) 0.299(0.134–0.668) 0.003 Urogenital caner 8(1.73%) 16(2.70%) 0.775(0.172–3.494) 0.740 Gynecologic cancer 45(9.72%) 80(13.51%) 0.636(0.255–1.581) 0.330 Other type of cancer 7(1.51%) 25(3.03%0 0.779(0.194–3.119) 0.724 Do you accept two doses of COVID-19 vaccine? No 396(85.53%) 269(45.44%) Ref / Yes 67(14.47%) 323(54.56%) 5.197(3.483–7.754) < 0.001 Risk of COVID-19 infection None 112(24.19%) 181(30.57%) Ref / Low 232(50.11%) 248(41.89%) 0.515(0.337–0.787) 0.002 Medium 52(11.23%) 90(15.20%) 0.921(0.524–1.621) 0.776 High 67(14.47%) 73(12.33%) 0.811(0.470–1.401) 0.452 Do you think it is necessary to accept COVID-19 booster vaccine? No 209(45.14%) 57(9.63%) Ref / Yes 254(54.86%) 535(90.37%) 4.596 (2.994–7.053) < 0.001 In general, do you think COVID-19 booster vaccine will cause side effects? No 279(60.26%) 486(82.09%) Ref / Yes 184(39.74%) 106(17.91%) 0.478(0.326–0.702) < 0.001 Do you think you will get seriously ill even if they get infected after getting the COVID-19 booster vaccine? No 176(38.01%) 188(31.76%) Ref / Yes 287(61.99%) 404(68.24%) 0.851(0.577–1.256) 0.417 Do you think the COVID-19 booster vaccine can increase protection against COVID-19? No 88(19.01%) 41(6.93%) Ref / Yes 375(80.99%) 551(93.07%) 1.640(0.807–3.331) 0.172 Do you think the COVID-19 booster vaccine can provide protection against new variants? No 98(21.17%) 68(11.49%) Ref / Yes 365(78.83%) 524(88.51%) 0.679(0.370–1.246) 0.212 Do you think the COVID-19 booster vaccine provides persistent protection? No 185(39.96%) 131(22.13%) Ref / Yes 278(60.04%) 461(77.87%) 1.290(0.873–1.906) 0.201 Do you think the COVID-19 booster vaccination may impact cancer treatment? No 72(15.55%) 347(58.61%) Ref / Yes 391(84.45%) 245(41.39%) 0.190(0.130–0.278) < 0.001 Do you think the COVID-19 booster vaccine is safe and effective? No 299(64.58%) 234(39.53%) Ref / Yes 164(35.42%) 358(60.43%) 1.797(1.267–2.548) 0.001 Are you willing to pay for the COVID-19 booster vaccine? No 340(73.43%) 364(61.49%) Ref / Yes 123(26.57%) 228(38.51%) 1.458(1.006–2.114) 0.047 Will you recommend the COVID-19 booster vaccine to your friends and family? No 80(17.28%) 24(4.05%) Ref / Yes 383(82.72%) 568(95.95%) 4.195(2.070–8.499) < 0.001 P -values indicate whether the adjusted OR of a particular sub-category is significant compared to the reference category. OR = odds ratio; CI: confidence interval; COVID-19: Coronavirus Disease 2019. OR indicated whether the variable will have a significant impact on the “COVID-19 booster vaccine” relationship Table 4 Hosmer-Lemeshow goodness-of-fit test of univariate analysis χ2 df p 8.546 8 0.382 In particular, cancer patients who were frequent smokers (OR = 3.182; 95% CI:1.422–7.119; P = 0.005 vs. non-smokers), those who had received two doses of the COVID-19 vaccine (OR = 5.197; 95% CI:3.483–7.754; P < 0.001 vs. unvaccinated individuals), those who believed that the COVID-19 booster vaccine was necessary (OR = 4.596; 95%CI:2.994–7.053; P < 0.001 vs. not necessary), those who believed that the COVID-19 booster vaccine was safe and effective (OR = 1.797; 95% CI:1.267–2.548; P = 0.001 vs. not safe and effective), those willing to pay for the COVID-19 booster vaccine (OR = 1.458; 95% CI:1.006–2.114; P = 0.047 vs. unwilling individuals), and those who would recommend the COVID-19 booster vaccine to friends and family (OR = 4.195; 95% CI:2.070–8.499; P < 0.001 vs. would not recommend) were more willing to receive the COVID-19 booster vaccine. On the other hand, cancer patients who lived in urban areas (OR = 0.651; 95% CI:0.456–0.930; P = 0.018 vs. rural area), digestive tract cancer (OR = 0.299; 95% CI:0.134–0.668; P = 0.003 vs. head and neck cancer), Risk of COVID-19 infection is low (OR = 0.515; 95% CI:0.337–0.787; P = 0.002 vs. none), those who believed that the COVID-19 booster vaccine would increase side effects (OR = 0.478; 95% CI:0.362–0.702; P < 0.001 vs. no side effect), and those who believed that the COVID-19 booster vaccine would impact cancer treatment (OR = 0.190; 95% CI:0.130–0.278; P < 0.001 vs. no impact) were more hesitant towards getting the COVID-19 booster vaccine. 3.5 Reasons for willingness to receive COVID-19 booster vaccine Amongst the 592 patients who expressed their willingness to receive the COVID-19 booster vaccine, 86.66% (513/592) indicated that the COVID-19 booster vaccine could enhance protection against COVID-19, 61.15% (362/592) indicated that getting the COVID-19 booster vaccine was a social responsibility, and 37.50% (222/592) indicated that they were aware of the safety and efficacy data of the vaccine (Table 5 ). Table 5 Reasons for willingness to receive COVID-19 booster vaccine (N = 592). Reasons N (%) The COVID-19 booster vaccine could enhance protection against COVID-19. 513 (86.66%) The COVID-19 booster vaccine was a social responsibility. 362 (61.15%) I am aware of the safety and efficacy data of the COVID-19 booster vaccine. 222 (37.50%) The benefits of COVID-19 booster vaccine overweigh the risks. 180 (30.41%) A policy of free access to COVID-19 booster vaccine. 173 (29.22%) I get introduction from the doctor about the COVID-19 booster vaccine. 128 (21.62%) Others have been vaccination. 77 (13.01%) 3.6 Reasons for unwillingness to accept COVID-19 booster vaccine Amongst the 463 patients who expressed why they resisted COVID-19 booster vaccine, 85.75% (397/463) were concerned that the vaccine would impact cancer treatment and progression, 45.14% (209/463) were concerned that the COVID-19 booster vaccine could cause adverse reactions, and 18.14% (84/463) indicated that the safety and efficacy data on the COVID-19 booster vaccine was lacking (Table 6 ). Table 6 Reasons for unwillingness to accept COVID-19 booster vaccine (N = 463) Reasons N (%) I was concerned that the COVID-19 booster vaccine would impact cancer treatment and progression. 397 (85.75%) I was concerned that the COVID-19 booster vaccine could cause adverse reactions. 209 (45.14%) The safety and efficacy data on the COVID-19 booster vaccine was lacking. 84 (18.14%) I have received a lot of negative information about the COVID-19 booster vaccine. 30 (6.48%) Vaccination go against everything I know about health. 28 (6.05%) I have low risk on COVID-19 Infection. 26 (5.62%) I had a bad experience with vaccinations. 13 (2.81%) 4. Discussion Effective control of the spread of COVID-19 is very critical. On January 3, 2022, a fourth shot of the COVID-19 vaccine was approved by the Ministry of Health of Israel for individuals aged ≥ 60 years who have already received the third booster shot and for the immunocompromised ones. On March 29 2022, the US FDA granted emergency use authorization to two vaccines as the fourth shot in individuals aged 50 years and above who have already received the booster shot and in immunocompromised individuals aged 12 years and above. Cancer patients have weakened immune systems, and infection with SARS-CoV-2 may result in very high mortality rates among the patients [ 23 , 24 ]. We conducted a cross-sectional study in China to assess the attitude and acceptance of cancer patients toward getting the COVID-19 booster vaccine before providing cancer patients with the COVID-19 booster vaccine. In this study, 56.11% of the participants were willing to receive the COVID-19 booster vaccine, while 43.89% remained hesitant. The vaccine acceptance rate was slightly lower than that reported in other similar studies. For instance, a 1-week cross-sectional study in China had previously revealed that 88.46% of the 1724 participants were willing to have their children receive the COVID-19 booster vaccine [ 25 ]. In another online cross-sectional survey of healthy workers in Saudi Arabia, 71.1% of the participants expressed their willingness to get a COVID-19 booster vaccine [ 26 ]. Similarly, an online cross-sectional survey of Iraqi adults indicated that 61.1% of the participants were willing to receive the COVID-19 booster vaccine [ 19 ]. The difference in vaccine acceptance rate between our study and others may be attributed to cancer patients being the main subjects of the study. Cancer patients are immunosuppressed compared to normal individuals and are hence more cautious about the COVID-19 booster vaccine. This may be because clinical trials reporting the safety and effectiveness of the COVID-19 booster vaccine in cancer patients are yet to be published. They constantly consider whether the side effects of the COVID-19 booster vaccine will worsen the condition. Therefore, conducting multi-center randomized controlled clinical trials as soon as possible and publishing the results might encourage cancer patients to receive COVID-19 booster vaccine. This study also shows that the media is the main trusted source of information, accounting for 52.13%, followed by government agencies, accounting for 51.37%, and friends and family, accounting for 41.80%, consistent with previous findings. For example, a survey in Beirut, Lebanon, revealed that most cancer patients learned about the COVID-19 vaccine through TV, radio broadcasts, and newspaper (89.2%), social media (55.9%), and friends, family, and neighbors (26.1%) [ 27 ]. In contrast, a cross-sectional survey performed in the US between 8th and 16th January 2021 revealed that the most common information sources of the COVID-19 vaccine for cancer patients were physicians, clinics and hospitals, followed by disease control and prevention centers and other state health institutions, and then family, friends, and colleagues [ 28 ]. Public skepticism towards vaccines and anti-vaccine movements are extremely common when a new vaccine is being developed. Understanding the relevant channels through which cancer patients receive information about the COVID-19 vaccine is thus extremely vital. Based on our findings, we recommend a further increase in publicity, active guidance from government agencies, and dissemination of vaccine-related data through social media to enable more cancer patients to become aware of the benefits of the booster vaccine. Patients’ willingness to receive the vaccine could be influenced by many factors. Amongst the nine independent predictors identified in this study, six promoted vaccine acceptance, while three resulted in vaccine hesitancy. According to relevant reports, smoking is the most obvious risk factor for the progression of COVID-19, which has also been confirmed by other studies. Therefore, cancer patients who often smoke are more fearful of COVID-19 and are more willing to receive the booster vaccine to enhance immunity [ 29 – 31 ]. Consistent with a cross-sectional survey of cancer patients in Tunisia, our multivariate logistic regression revealed that the safety and efficacy of the booster vaccine was an important factor that influenced acceptance [ 32 ]. A survey in Poland showed that 41.3% of cancer patients were fully aware of the potential value and safety of vaccination [ 33 ]. During the COVID-19 pandemic, several vaccines, such as the Ad5-nCoV, CoronaVac, and BBIBP-CorV, were approved for the prevention of related diseases in China. The safety and efficacy of these vaccines have been fully validated, and the results have been published in the Lancet and its family of journals [ 34 – 38 ]. Herein, many cancer patients were willing to receive the booster shot because they believed it was safe and efficient. This study also demonstrated that the belief that the booster vaccine would increase side effects and affect tumor treatment was the major factor contributing to vaccine hesitancy. In a survey conducted across 3 cancer centers in Tunisia, multivariate logistic regression revealed that cancer patients who believed that the vaccine could interfere with treatment efficacy or impact cancer outcome were more likely to refuse vaccination [ 39 ]. Of note, the side effects of the COVID-19 vaccine on cancer patients remain unclear because of their non-inclusion in most clinical trials and as a population for analysis in subsequent studies [ 40 ]. A prospective, single-center observational study at the Fox Chase Cancer Center showed that the number of reported adverse events was nearly identical between patients with and without cancer after all participants received two shots of the Pfizer BNT162b2 vaccine. Notably, active cancer treatment had little impact on the adverse event profile [ 41 ]. A phase I trial revealed that the median neutralizing antibody titer significantly increased one week after the third shot of the BNT162b2 mRNA vaccine in 31 solid tumor patients. However, no improvement was observed in T-cell response, and adverse reactions were mild, which suggested that the vaccine may have immunological benefits in cancer patients undergoing active chemotherapy [ 42 ]. Understanding the effect of the COVID-19 booster vaccine on cancer progression is thus an important premise for promoting vaccination in cancer patients. Moreover, paying for the COVID-19 booster vaccine influenced the participants’ decision to be vaccinated. This finding was similar to those of an online cross-sectional study in Jordan [ 43 ]. In Nigeria, most respondents (2496/3076, 81.1%) were unwilling to pay for the COVID-19 vaccine [ 44 ]. In Pakistan, 33.9% of participants were willing to pay 1000 Pakistani Rupees for the COVID-19 vaccine [ 45 ]. These results indicate that the vaccine cost is a major obstacle that affects vaccination. The free COVID-19 vaccine in China should thus be continued because the policy is favorable for improving vaccine acceptance among Chinese individuals. Despite the valuable findings, this study was limited by several factors. First, this was a cross-sectional study, which cannot directly infer causality. Secondly, some participants were elderly, while others had no access to the internet, which hindered them from filling out the survey. In addition, some individuals had no access to social media, especially the elderly and those without internet access. Thirdly, we sent out the survey to cancer patients online, and these populations may find it difficult to solve problems, leading to the phenomenon of estimated responses. Therefore, the sample distribution could have been uneven, leading to limited sample representativeness. The study had a small sample size; thus, future multi-center large cohort studies will be required to validate the findings. The attitude and willingness of cancer patients to receive the booster shot may also change over time as the SARS-CoV-2 mutates and vaccine campaigns continue to grow. The findings obtained may, therefore, not be applicable after some time. 5 Conclusion This study examined the demographic and sociological characteristics of cancer patients and their awareness and attitudes towards COVID-19 booster vaccines and analyzed the independent predictors influencing patient vaccination, so as to better understand why cancer patients are not vaccinated. This study recommends expanding the channels, increasing the publicity, and providing cancer patients with individualized treatment options after adequate risk assessment to allow more cancer patients to benefit from the COVID-19 booster vaccine. Moreover, this study recommends developing specific COVID-19 vaccines for cancer patients based on their pathogenic characteristics to improve vaccine safety and efficacy. That is to say, the governments need to provide strong support and researchers attach great importance to developing specific COVID-19 vaccines for cancer patients. This study recommends developing healthcare policies appropriate for cancer patients to facilitate their acceptance of vaccines, such as publishing the safety and effectiveness of vaccines, providing individualized treatment options after adequate risk assessment and developing specific COVID-19 vaccines suitable for cancer patients. Declarations Conflict of Interest: The authors have no conflict of interests related to this publication. Funding Statement: This work was supported in part by the National Natural Science Foundation of China (Nos. 82030117 and 82074203). Ethics approval and Informed consent: The analysis was approved by the Ethics Committee, which mainly came from the following two organizations: the first was Chaohu Hospital of Anhui Medical University, with the approval number of KYXM-20210501; The First Affiliated Hospital of Naval Medical University (CHEC2013-119). In the analysis, all the respondents fully grasped the objectives and procedures of the analysis, and also signed an oral informed consent. All procedures in the study were performed in accordance with the Declaration of Helsinki. Author Contributions: JH, and MY designed the study. MY, PW, MW and SQZ performed the study and their analyses. MY, QY, YBM and XWX, were responsible for data collection. JH and QMZ performed data analyses. All authors participated in data interpretation, manuscript review and writing. PW and JH were responsible for preparation of the Tables and Figure. All authors contributed to the scientific discussion of the data and of the manuscript. Acknowledgments: This study acknowledges the contributions of all participant. Data Availability Statement: Has data associated with your study been deposited into a publicly available repository? No. Has data associated with your study been deposited into a publicly available repository? 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Acceptance and attitudes toward COVID-19 vaccines: A cross-sectional study from Jordan. PLoS ONE. 2021;16(4):e0250555. Al-Mustapha AI, Okechukwu O, Olayinka A, Muhammed OR, Oyewo M, Owoicho SA, Abubakar AT, Olabisi A, Jibril A, Ereh S, Fakayode OE, Ogundijo OA, Elelu N, Adetunji VO. A national survey of COVID-19 vaccine acceptance in Nigeria. Vaccine. 2022;40(33):4726–31. Tahir MJ, Saqlain M, Tariq W, Waheed S, Tan SHS, Nasir SI, Ullah I, Ahmed A. Population preferences and attitudes towards COVID-19 vaccination: a cross-sectional study from Pakistan. BMC Public Health. 2021;21(1):1759. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4240784","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":290104022,"identity":"0c468ebf-2c10-4ee6-815d-d9261b84eab3","order_by":0,"name":"Man Yao","email":"","orcid":"","institution":"Shanghai University of Traditional Chinese Medicine","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Man","middleName":"","lastName":"Yao","suffix":""},{"id":290104023,"identity":"4ef75d16-0dfc-4a2e-a658-970c9ecb2efb","order_by":1,"name":"Peng Wang","email":"","orcid":"","institution":"the Sixth Medical Center of PLA General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Peng","middleName":"","lastName":"Wang","suffix":""},{"id":290104024,"identity":"70461ead-eb9f-4f2e-867e-8800d3b9822d","order_by":2,"name":"Meng Wang","email":"","orcid":"","institution":"The First Affiliated Hospital of Naval Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Meng","middleName":"","lastName":"Wang","suffix":""},{"id":290104025,"identity":"c818f097-219c-4f0f-a18c-2ce7177190d8","order_by":3,"name":"Sheng-qi Zheng","email":"","orcid":"","institution":"The PLA Navy Anqing Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sheng-qi","middleName":"","lastName":"Zheng","suffix":""},{"id":290104026,"identity":"bcd26db8-27b8-4610-a791-31d440e1aaf5","order_by":4,"name":"Xiao-wan Xu","email":"","orcid":"","institution":"The First Affiliated Hospital of Naval Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Xiao-wan","middleName":"","lastName":"Xu","suffix":""},{"id":290104027,"identity":"fbdd5c50-71ad-43b8-b160-13981c2362cc","order_by":5,"name":"Qing-mei Zhang","email":"","orcid":"","institution":"Chaohu Hospital of Anhui Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Qing-mei","middleName":"","lastName":"Zhang","suffix":""},{"id":290104028,"identity":"00b69a42-9cb2-4c15-9819-05c198097e89","order_by":6,"name":"Qin Yu","email":"","orcid":"","institution":"Shanghai University of Traditional Chinese Medicine","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Qin","middleName":"","lastName":"Yu","suffix":""},{"id":290104029,"identity":"af6de3f1-4323-4d11-ab3f-21726d2b0f7d","order_by":7,"name":"Hao-ran Qin","email":"","orcid":"","institution":"Second Military Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Hao-ran","middleName":"","lastName":"Qin","suffix":""},{"id":290104030,"identity":"ecf27935-ca71-4688-ad4e-2a821d9a8681","order_by":8,"name":"Yong-bin Meng","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyklEQVRIiWNgGAWjYLCCBwwHGPgYmA8c+PCDWC0JQC1sDGyJB2f2kKaFx/gwBxsRqvnbe8weJFTcSWxj7/lwmIGHQZ5f7AB+LRJnzpgbJJx5ltjGc3bD4QILBsOZsxPwazGQyDGTSGw7nNgmkbvh8AwehgSD20Rp+QfUIv/mwWEeNqK1NIBs4WEgTovEmWPlBgnHnhm38aQZAANZgrBf+Nubtz34UHNHtp/98OMPH37YyPNLE9ACBChxIUFQOYaWUTAKRsEoGAWYAADkMkhC/MpVawAAAABJRU5ErkJggg==","orcid":"","institution":"The First Affiliated Hospital of Naval Medical University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Yong-bin","middleName":"","lastName":"Meng","suffix":""},{"id":290104031,"identity":"19d86573-be3e-49c7-b90e-c579923e342e","order_by":9,"name":"Jing Hong","email":"","orcid":"","institution":"Peking University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jing","middleName":"","lastName":"Hong","suffix":""}],"badges":[],"createdAt":"2024-04-09 08:58:35","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4240784/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4240784/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1016/j.heliyon.2024.e26869","type":"published","date":"2024-02-01T18:47:58+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":55004708,"identity":"681afe1e-7c6c-41ec-b531-ef7cee3683fd","added_by":"auto","created_at":"2024-04-19 18:47:10","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":64743,"visible":true,"origin":"","legend":"\u003cp\u003eProportion of the sources from which the study participants obtained information about the COVID-19 booster vaccine. A. The sources of information about COVID-19 booster vaccines of vaccine acceptance group (N=592), B. The sources of information about COVID-19 booster vaccines of vaccine hesitancy group (N=463).\u003c/p\u003e","description":"","filename":"Figure.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4240784/v1/034c054ba9ab2607677fdbf2.jpg"},{"id":55005913,"identity":"2692f589-2966-40f8-b074-91ad2e00ad93","added_by":"auto","created_at":"2024-04-19 18:55:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":682579,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4240784/v1/40774785-95f0-43c5-a091-9516a408055c.pdf"},{"id":55004715,"identity":"4bd4df33-2ce2-4eef-a01d-d8c0bb000cfb","added_by":"auto","created_at":"2024-04-19 18:47:15","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":18631,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementtable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-4240784/v1/9fbcf24aa5b14413d29a250c.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"A survey on the attitude and willingness of Chinese cancer patients toward a COVID-19 booster vaccine","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eThe ongoing COVID-19 pandemic has imposed severe stress on economic recovery and development worldwide and has strained the already fragile medical and healthcare systems of some developing countries. More than 772\u0026nbsp;million confirmed COVID-19 cases and deaths were reported globally by November 22 2023, totaling more than 6.98\u0026nbsp;million cases [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs a vulnerable group, cancer patients are among the most affected individuals during public health crisis. Previous studies postulated that cancer patients who contract COVID-19 have higher risks of complications and exacerbated disease or even death [\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Although active malignancy has been shown to be an independent risk factor in most studies, this increased risk may be attributed to the co-occurrence of risk factors associated with the general population [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In the first wave of the COVID-19 outbreak, there was an unusually high death rate among active cancer patients with COVID-19, reaching up to about 40%. However, the rate was reduced to about 25% in a subsequent wave in European countries in 2021. The incidence of long-term COVID-19 sequelae in cancer patients is estimated at 15\u0026ndash;30% [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The first results of the European Society for Medical Oncology (ESMO) COVID-19 and CAncer REgistry (ESMO-CoCARE) revealed that patient/cancer characteristics related to gender, ethnicity, poor fitness, comorbidities, systemic inflammation, and the presence of an active malignancy were associated with moderate/severe disease and adverse outcomes from COVID-19 in cancer patients [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eVaccination is generally regarded as the most effective means of combating infectious diseases. Unfortunately, the few pivotal COVID-19 vaccine clinical trials have only included a small number of cancer patients [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], reducing the clarity of the potential risks of the vaccine in patients. This phenomenon has greatly affected the determination of cancer patients to be vaccinated. According to a survey conducted in Italy, only 11.2% of cancer patients were unwilling to receive the COVID-19 vaccine [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. A cross-sectional analysis in Victoria, Australia, reported that 84% of respondents had a positive perception towards COVID-19 vaccination, 10% were undecided, and 6% had a negative perception towards vaccination. Amongst the respondents, the number of patients injected with one or more doses of vaccine reached 65%, and 35% were unvaccinated [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. A survey in eastern China reported that the proportion of vaccination with COVID-19 vaccine among cancer patients reached 35.54%, and 40.01% of the patients were receptive to the vaccine, while 24.05% were skeptical about the COVID-19 vaccine [\u003cspan additionalcitationids=\"CR13 CR14\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral countries are currently providing COVID-19 booster vaccines, which are defined as the third and above shots of the COVID-19 vaccine. Available data indicate that the COVID-19 booster vaccine significantly prolongs immune response during the omicron B.1.1.529 epidemic. Nonetheless, whether it is necessary for cancer patients in China to be injected with the COVID-19 booster vaccine still needs further verification [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Some medical experts are concerned that vaccination may overload the immune system and trigger a \u0026ldquo;cytokine storm,\u0026rdquo; resulting in severe toxicities that can damage organs and even lead to death. There are no direct answers to this question, but experts believe that cancer patients may benefit from COVID-19 vaccines based on data from other epidemic diseases [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. This study aimed to determine the attitude and willingness of Chinese cancer patients toward the COVID-19 booster vaccines and to distinguish independent predictors that may impact the vaccination of cancer patients.\u003c/p\u003e"},{"header":"2. Materials/Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study design and subjects\u003c/h2\u003e \u003cp\u003eThe study employed a cross-sectional and anonymous design, which was conducted online in China for six months from July 1, 2022, and January 1, 2023. A self-reporting survey was sent to adult cancer patients through the \u0026ldquo;Wenjuanxing\u0026rdquo; online survey platform. Our team sent the questionnaire link of the \"Wenjuanxing\" platform to participants who have received anti-tumor treatment in the hospital or are receiving anti-tumor treatment in the hospital through wechat groups, websites, hospital posters, and other means. Participants clicked the link to start answering questions. Cancer patients with mental disabilities were excluded. Survey participation was voluntary and took about eight minutes to complete. There was no material reward for participation.\u003c/p\u003e \u003cp\u003eThe estimated sample size of this study was mainly based on the assumption that 61.1% of the participants were voluntarily vaccinated with COVID-19 vaccine [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The actual sample size was calculated as follows:\u003c/p\u003e \u003cp\u003e \u003cspan class=\"InlineEquation\"\u003e \u003cspan class=\"mathinline\"\u003e\\({\\text{n = }}{{\\text{Z}}^{\\text{2}}}_{{{\\text{1}}\\,{\\text{-}}\\,{\\text{\\varvec{\\alpha}/2}}}}P\\left( {{\\text{1 -}}P} \\right){\\text{/}}{{\\text{e}}^{\\text{2}}}\\)\u003c/span\u003e \u003c/span\u003e \u003c/p\u003e \u003cp\u003eWhere n denotes the minimum sample size, Z\u003csup\u003e2\u003c/sup\u003e denotes the 95% confidence interval (CI)=(1.96)\u003csup\u003e2\u003c/sup\u003e, \u003cem\u003eP\u003c/em\u003e denotes the previously estimated morbidity rate, and e denotes the error\u0026thinsp;=\u0026thinsp;0.04. Given a non-response rate of 10%, the minimum sample size for this study was 628 participants.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Survey\u003c/h2\u003e \u003cp\u003eA self-reporting survey was developed based on a review of relevant studies [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The survey mainly evaluated the attitude and acceptance of patients toward the COVID-19 booster vaccine. The survey was designed in Chinese, translated into English, and then back to Chinese, followed by a series of validations before release. A small pilot survey comprising 50 cancer patients was first conducted to test the authenticity and validity of the survey and to identify any potential problems during data collection. In this pilot study, respondents were invited to complete the questionnaire, which took an average of 5 minutes. After completing the questionnaire, we interviewed each respondent and asked them about possible problems with the questionnaire. These interviews took an average of 9 minutes, and no problem was identified in this pilot survey.\u003c/p\u003e \u003cp\u003eThe response variable for this study was the acceptance of Chinese cancer patients to get a booster vaccine. We measured the temperature of the interviewees and inquired whether the patients wanted the COVID-19 booster vaccine. If the answer given by the patient after the inquiry was \u0026ldquo;Yes,\u0026rdquo; the questioner asked why the patient was receptive to the vaccine. If the answer after the above inquiry was \u0026ldquo;No,\u0026rdquo; the questioner asked why the respondents were reluctant to accept the vaccine.\u003c/p\u003e \u003cp\u003eSeveral explanatory variables were also collected in this study, including the demographic data (The detailed questionnaire survey content is available at Supplement Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.). The demographic data of the respondents mainly involves the following aspects: age, male/female, BMI, whether married or not, current residence address, education level, actual job category, total income for one month, and whether the respondents had smoking and drinking behaviors. The participants\u0026rsquo; clinical characteristics included cancer category, time of cancer detection, any underlying disease, presence of complications, presence of metastasis, vaccination with 2 shots of the vaccine, and risk of COVID-19. The participant\u0026rsquo;s perception of the vaccine was determined based on these questions: Do you think a booster shot is necessary? Do you think the vaccine can increase side effects? Do you think people will get seriously ill even if they get infected after getting the booster vaccine? Do you think the vaccine can increase protection against COVID-19? Do you think the vaccine can provide protection against new variants? Do you think the vaccine provides persistent protection? Do you think the booster vaccine may impact cancer treatment? Do you think the booster vaccine is safe and effective? Are you willing to pay for the vaccine? Will you recommend the booster vaccine to your friends and family? The possible answers to these questions were \u0026ldquo;yes\u0026rdquo; or \u0026ldquo;no.\u0026rdquo;\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Statistical analysis\u003c/h2\u003e \u003cp\u003eQuestionnaires with missing data will be considered incomplete and will not be included in this study. Sociodemographic characteristics, clinical characteristics, and attitudes towards the vaccine of the participants were analyzed using descriptive statistics and expressed as percentages. All variables in this study are categorical variables, and the most answers are presented as \"yes\" and \"no\". In statistics, \"no\" is coded as 0, \"yes\" is coded as 1, and other answers are coded as 0\u0026ndash;3 according to the degree of the event, for example, in \"Risk of COVID-19 infection\" group, \"None\" is coded as 0, \"Low\" is coded as 1, \"Medium\" is coded as 2, and \"High\" is coded as 3. The relationship between the independent variables (general participant information and perception of the COVID-19 booster vaccine) and the dependent variable (intention towards the COVID-19 booster vaccine) was assessed through a chi-squared test. Variables with a \u003cem\u003eP\u003c/em\u003e-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 in the univariate analyses were considered meaningful and were used in multivariate logistic regression analyses to identify independent predictors influencing the acceptance. The adjusted odds ratio (AOR) and 95% CI of these variables were then reported, which was mainly used to quantify the correlation strength between exposure factors and outcome events. If the obtained \u003cem\u003eP\u003c/em\u003e-value was lower than 0.05, then the result was considered to have a statistical value. All the statistical analyses were conducted using SPSS 21.0 software (SPSS Inc., IL in Chicago, USA).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Ethics review and approval\u003c/h2\u003e \u003cp\u003e The study was approved by the Ethics Committee of the Chaohu Hospital of Anhui Medical University (KYXM-20210501) and the First Affiliated Hospital of Naval Medical University (CHEC2013-119). All respondents fully grasped the objectives and procedures of the study and signed an oral informed consent form.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Characteristics and acceptance of participants towards the COVID-19 booster vaccine\u003c/h2\u003e \u003cp\u003eA total of 1122 participants took part in filling out the survey. Among them, 36 did not complete their sociodemographic information, and 31 completed the questionnaire in less than 2.5 minutes, a total of 1055 participants completed the questionnaire, bringing the overall response rate in this cross-sectional study to 94.11%.\u003c/p\u003e \u003cp\u003eAmong the 1055 participants, 592 indicated willingness towards receiving the COVID-19 booster vaccine (56.11% vaccine acceptance rate), while 463 indicated unwillingness towards receiving the COVID-19 booster vaccine (43.89% vaccine hesitancy rate) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Of the 1055 participants, 58.58% were aged 40\u0026ndash;60 years, 63.22%were males, 93.74% were married, 49.86% had an average monthly income of \u0026lt;\u0026thinsp;3000 CNY, 81.33% were non-smokers, and 73.85% had no family history of cancer. Most participants had no underlying conditions.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics and clinical features of participants.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eItems under investigation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAll participants (N\u0026thinsp;=\u0026thinsp;1055)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eIntention to use vaccine\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHesitancy (N\u0026thinsp;=\u0026thinsp;463)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAcceptance (N\u0026thinsp;=\u0026thinsp;592)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAge (Year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.694\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e107(10.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50(10.80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57(9.63%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e618(58.58%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e265(57.24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e353(59.63%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e330(31.38%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e148(31.97%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e182(30.74%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.462\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e388(36.78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e176(38.01%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e212(35.81%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e667(63.22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e287(61.99%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e380(64.19%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.594\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;18.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81(7.68%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38(8.21%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43(7.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18.5\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e551(52.23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e238(51.40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e313(52.87%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24\u0026ndash;28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e337(31.94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e144(31.10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e193(32.60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e86(8.15%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43(9.29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43(7.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23(2.18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(0.65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20(3.38%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e989(93.74%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e442(95.46%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e547(92.40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced/Widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43(4.08%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(3.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25(4.22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eResidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e351(33.27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e124(26.78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e227(38.34%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e704(66.73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e339(73.22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e365(61.66%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.603\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;Senior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e677(64.17%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e290(62.63%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e387(65.37%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollege degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e188(17.82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88(19.01%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100(17.82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;Bachelor\u0026rsquo;s degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e190(18.01%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85(18.36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e190(18.01%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e318(30.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e130(28.08%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e188(31.76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e344(32.61%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e142(30.67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e202(34.12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e392(37.25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e191(41.25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e202(34.12%0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage monthly income (CNY)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.524\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;3000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e526(49.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e222(47.95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e304(51.35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3000\u0026ndash;8000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e407(38.58%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e184(39.74%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e223(36.67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;8000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e122(11.56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57(12.31%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65(10.98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eCurrent smoking status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e858(81.33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e395(85.31%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e463(78.21%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccasionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e127(12.04%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47(10.15%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80(13.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrequently\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70(6.64%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(4.54%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49(8.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eCurrent drinking status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e857(81.23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e402(86.83%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e455(76.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccasionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e168(15.92%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52(11.23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e116(19.59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrequently\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30(2.84%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(1.94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21(3.55%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eCancer type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHead and neck cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e66(6.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(4.10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47(7.94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory and thoracic cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e194(18.39%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70(15.12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e124(20.95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDigestive tract cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e614(58.20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e314(67.82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e300(50.68%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrogenital caner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24(2.27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(1.73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16(2.70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGynecologic cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e125(11.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45(9.72%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80(13.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther cancer type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32(3.03%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(1.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25(3.03%0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eTime of cancer diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.195\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e301(28.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118(25.49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e183(30.91%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;3 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e389(36.87%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e176(38.01%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e213(35.98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e159(15.07%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78(16.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81(13.68%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e206(19.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91(19.65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115(19.43%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eOther underlying diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.392\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e726(68.82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e325(70.19%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e401(67.74%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e329(31.18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e138(29.81%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e191(32.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eFamily history of cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.584\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e779(73.84%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e338(73.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e441(74.49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e276(26.16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e125(27.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e151(25.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eComplication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.520\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e906(85.88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e394(85.10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e512(85.88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e149(14.12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69(14.90%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80(13.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eMetastasis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.106\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e747(70.81%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e316(68.25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e431(72.80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e308(29.19%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e147(31.75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e161(27.20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you accept two doses of COVID-19 vaccine?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e665(63.03%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e396(85.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e269(45.44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e390(36.97%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67(14.47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e323(54.56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eRisk of COVID-19 infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e293(27.77%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112(24.19%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e181(30.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e480(45.50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e232(50.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e248(41.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e142(13.46%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52(11.23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90(15.20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e140(13.27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67(14.47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73(12.33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eParticipants were divided into two groups, the \u0026ldquo;Hesitancy\u0026rdquo; and \u0026ldquo;Acceptance\u0026rdquo; groups, and the \u003cem\u003eP\u003c/em\u003e-values were obtained via a chi-squared test between the two groups. BMI: body mass index; CNY: Chinese yuan; COVID-19: Coronavirus Disease 2019.\u003c/p\u003e \u003cp\u003eSociodemographic characteristics showed that marital status, residence, current smoking status, and current drinking status, cancer type, and risk of COVID-19 infection were highly varied between the acceptance group and vaccine-hesitant group (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The percentage of the participants who received two doses of COVID-19 vaccine shots also differed between the groups, with a P value less than 0.05.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Sources of material regarding the COVID-19 vaccine\u003c/h2\u003e \u003cp\u003eIn the vaccine acceptance group, The government agencies was the largest source of the information from which most of the participants obtained information about COVID-19 booster vaccine, accounting for 61.31%, followed by media ( 363/592, 61.32%), friends and families (259/592, 43.75%), and others (82/592, 13.85%), while in the vaccine hesitancy group, the largest sources of information about the COVID-19 vaccine were media (223/463, 48.16%), followed by government agencies (179/463, 38.66%) and friends and families (152/463, 32.83%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Participants\u0026rsquo; attitudes towards the COVID-19 booster vaccine\u003c/h2\u003e \u003cp\u003eThe attitudes towards the COVID-19 booster vaccine significantly differed between the acceptance group and vaccine-hesitant group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 for all 10 questions) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Over three-quarters of the patients (789/1055, 74.79%) believed that COVID-19 booster vaccine was necessary, while only about a quarter of the patients (290/1055, 27.49%) indicated that COVID-19 booster vaccine will cause side effects. In the same line, 65.50% (691/1055) of the patients supposed that they would not get seriously ill even if they get infected after getting the COVID-19 booster vaccine. Most patients believed that the COVID-19 booster vaccine could enhance protection against COVID-19 (926/1055, 87.77%), was protective against new variants (889/1055, 84.27%), and would provide persistent protection (739/1055, 70.05%). Over half of the patients (636/1055, 60.28%) thought that the COVID-19 booster vaccine could affect cancer treatment, while about half of the patients (522/1055, 49.48%) thought that the COVID-19 booster vaccine was safe and effective. Only 33.27% (351/1055) of patients were willing to pay for the COVID-19 booster vaccine. Among all patients, 90.14% (951/1055) of patients recommended COVID-19 booster vaccine to their friends and family.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipants\u0026rsquo; attitudes towards the COVID-19 booster vaccine.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eItems under investigation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAll participants (N\u0026thinsp;=\u0026thinsp;1055)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eIntention\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHesitancy (N\u0026thinsp;=\u0026thinsp;463)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAcceptance (N\u0026thinsp;=\u0026thinsp;592)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think it is necessary to accept COVID-19 booster vaccine?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e266(25.21%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e209(45.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57(9.63%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e789(74.79%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e254(54.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e535(90.37%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eIn general, do you think COVID-19 booster vaccine will cause side effects?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e765(72.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e279(60.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e486(82.09%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e290(27.49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e184(39.74%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e106(17.91%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think you will get seriously ill even if they get infected after getting the COVID-19 booster vaccine?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e364(34.50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e176(38.01%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e188(31.76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e691(65.50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e287(61.99%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e404(68.24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think the COVID-19 booster vaccine can increase protection against COVID-19?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e129(12.23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88(19.01%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41(6.93%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e926(87.77%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e375(80.99%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e551(93.07%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think the COVID-19 booster vaccine can provide protection against new variants?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e166(15.73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98(21.17%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68(11.49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e889(84.27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e365(78.83%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e524(88.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think the COVID-19 booster vaccine provides persistent protection?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e316(9.95%%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e185(39.96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e131(22.13%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e739(70.05%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e278(60.04%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e461(77.87%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think the COVID-19 booster vaccination may impact cancer treatment?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e419(39.72%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72(15.55%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e347(58.61%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e636(60.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e391(84.45%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e245(41.39%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think the COVID-19 booster vaccine is safe and effective?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e533(50.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e299(64.58%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e234(39.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e522(49.48%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e164(35.42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e358(60.43%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAre you willing to pay for the COVID-19 booster vaccine?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e704(66.73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e340(73.43%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e364(61.49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e351(33.27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e123(26.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e228(38.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eWill you recommend the COVID-19 booster vaccine to your friends and family?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e104(9.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80(17.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24(4.05%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e951(90.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e383(82.72%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e568(95.95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe study participants were divided into \u0026ldquo;Hesitancy\u0026rdquo; and \u0026ldquo;Acceptance\u0026rdquo; groups for comparative analysis, and the \u003cem\u003eP\u003c/em\u003e-values were calculated via a chi-squared test between the two groups. COVID-19: Coronavirus Disease 2019.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Independent predictors that impact COVID-19 booster vaccination\u003c/h2\u003e \u003cp\u003eSeventeen significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) variables were identified through univariate analysis. Multivariate logistic regression of the 17 variables revealed 9 variables that significantly impacted the participants\u0026rsquo; willingness to get the COVID-19 booster vaccine (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows the goodness of fit of the multivariate logistic regression model judged by the Hosmer-Lemeshow goodness of fit test. The model passed the Hosmer-Lemeshow goodness of fit test, and the goodness of fit of the model was good.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIndependent predictors of intention to accept COVID-19 booster vaccine.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eIntention to use vaccine\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHesitancy (N\u0026thinsp;=\u0026thinsp;463)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAcceptance (N\u0026thinsp;=\u0026thinsp;592)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(0.65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20(3.38%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e442(95.46%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e547(92.40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.684(0.149\u0026ndash;3.148)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.626\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced/Widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18(3.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(4.22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.700(0.123\u0026ndash;3.971)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.687\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eResidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e124(26.78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e227(38.34%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e339(73.22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e365(61.66%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.651(0.456\u0026ndash;0.930)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eCurrent smoking status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e395(85.31%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e463(78.21%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccasionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47(10.15%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80(13.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.283(0.732\u0026ndash;2.251)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.384\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21(4.54%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49(8.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.182(1.422\u0026ndash;7.119)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eCurrent drinking status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e402(86.83%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e455(76.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccasionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52(11.23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e116(19.59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.320(0.793\u0026ndash;2.197)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.286\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9(1.94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(3.55%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.468(0.447\u0026ndash;4.819)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.526\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eType of cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHead and neck cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19(4.10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47(7.94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory and thoracic cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70(15.12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e124(20.95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.585(0.246\u0026ndash;1.387)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.223\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDigestive tract cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e314(67.82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e300(50.68%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.299(0.134\u0026ndash;0.668)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrogenital caner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8(1.73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(2.70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.775(0.172\u0026ndash;3.494)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.740\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGynecologic cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45(9.72%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80(13.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.636(0.255\u0026ndash;1.581)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.330\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther type of cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7(1.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(3.03%0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.779(0.194\u0026ndash;3.119)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.724\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you accept two doses of COVID-19 vaccine?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e396(85.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e269(45.44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e67(14.47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e323(54.56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.197(3.483\u0026ndash;7.754)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eRisk of COVID-19 infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112(24.19%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e181(30.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e232(50.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e248(41.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.515(0.337\u0026ndash;0.787)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52(11.23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90(15.20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.921(0.524\u0026ndash;1.621)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.776\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e67(14.47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73(12.33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.811(0.470\u0026ndash;1.401)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.452\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think it is necessary to accept COVID-19 booster vaccine?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e209(45.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57(9.63%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e254(54.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e535(90.37%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.596 (2.994\u0026ndash;7.053)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eIn general, do you think COVID-19 booster vaccine will cause side effects?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e279(60.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e486(82.09%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e184(39.74%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e106(17.91%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.478(0.326\u0026ndash;0.702)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think you will get seriously ill even if they get infected after getting the COVID-19 booster vaccine?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e176(38.01%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e188(31.76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e287(61.99%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e404(68.24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.851(0.577\u0026ndash;1.256)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.417\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think the COVID-19 booster vaccine can increase protection against COVID-19?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e88(19.01%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41(6.93%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e375(80.99%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e551(93.07%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.640(0.807\u0026ndash;3.331)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.172\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think the COVID-19 booster vaccine can provide protection against new variants?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e98(21.17%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68(11.49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e365(78.83%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e524(88.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.679(0.370\u0026ndash;1.246)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.212\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think the COVID-19 booster vaccine provides persistent protection?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e185(39.96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e131(22.13%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e278(60.04%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e461(77.87%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.290(0.873\u0026ndash;1.906)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think the COVID-19 booster vaccination may impact cancer treatment?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72(15.55%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e347(58.61%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e391(84.45%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e245(41.39%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.190(0.130\u0026ndash;0.278)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eDo you think the COVID-19 booster vaccine is safe and effective?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e299(64.58%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e234(39.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e164(35.42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e358(60.43%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.797(1.267\u0026ndash;2.548)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAre you willing to pay for the COVID-19 booster vaccine?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e340(73.43%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e364(61.49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e123(26.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e228(38.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.458(1.006\u0026ndash;2.114)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.047\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eWill you recommend the COVID-19 booster vaccine to your friends and family?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80(17.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(4.05%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e/\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e383(82.72%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e568(95.95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.195(2.070\u0026ndash;8.499)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eP\u003c/em\u003e-values indicate whether the adjusted OR of a particular sub-category is significant compared to the reference category. OR\u0026thinsp;=\u0026thinsp;odds ratio; CI: confidence interval; COVID-19: Coronavirus Disease 2019. OR indicated whether the variable will have a significant impact on the \u0026ldquo;COVID-19 booster vaccine\u0026rdquo; relationship\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHosmer-Lemeshow goodness-of-fit test of univariate analysis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eχ2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8.546\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.382\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn particular, cancer patients who were frequent smokers (OR\u0026thinsp;=\u0026thinsp;3.182; 95% CI:1.422\u0026ndash;7.119; \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.005 vs. non-smokers), those who had received two doses of the COVID-19 vaccine (OR\u0026thinsp;=\u0026thinsp;5.197; 95% CI:3.483\u0026ndash;7.754; \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 vs. unvaccinated individuals), those who believed that the COVID-19 booster vaccine was necessary (OR\u0026thinsp;=\u0026thinsp;4.596; 95%CI:2.994\u0026ndash;7.053; \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 vs. not necessary), those who believed that the COVID-19 booster vaccine was safe and effective (OR\u0026thinsp;=\u0026thinsp;1.797; 95% CI:1.267\u0026ndash;2.548; \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001 vs. not safe and effective), those willing to pay for the COVID-19 booster vaccine (OR\u0026thinsp;=\u0026thinsp;1.458; 95% CI:1.006\u0026ndash;2.114; \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.047 vs. unwilling individuals), and those who would recommend the COVID-19 booster vaccine to friends and family (OR\u0026thinsp;=\u0026thinsp;4.195; 95% CI:2.070\u0026ndash;8.499; \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 vs. would not recommend) were more willing to receive the COVID-19 booster vaccine. On the other hand, cancer patients who lived in urban areas (OR\u0026thinsp;=\u0026thinsp;0.651; 95% CI:0.456\u0026ndash;0.930; \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.018 vs. rural area), digestive tract cancer (OR\u0026thinsp;=\u0026thinsp;0.299; 95% CI:0.134\u0026ndash;0.668; \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003 vs. head and neck cancer), Risk of COVID-19 infection is low (OR\u0026thinsp;=\u0026thinsp;0.515; 95% CI:0.337\u0026ndash;0.787; P\u0026thinsp;=\u0026thinsp;0.002 vs. none), those who believed that the COVID-19 booster vaccine would increase side effects (OR\u0026thinsp;=\u0026thinsp;0.478; 95% CI:0.362\u0026ndash;0.702; \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 vs. no side effect), and those who believed that the COVID-19 booster vaccine would impact cancer treatment (OR\u0026thinsp;=\u0026thinsp;0.190; 95% CI:0.130\u0026ndash;0.278; \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 vs. no impact) were more hesitant towards getting the COVID-19 booster vaccine.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Reasons for willingness to receive COVID-19 booster vaccine\u003c/h2\u003e \u003cp\u003eAmongst the 592 patients who expressed their willingness to receive the COVID-19 booster vaccine, 86.66% (513/592) indicated that the COVID-19 booster vaccine could enhance protection against COVID-19, 61.15% (362/592) indicated that getting the COVID-19 booster vaccine was a social responsibility, and 37.50% (222/592) indicated that they were aware of the safety and efficacy data of the vaccine (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eReasons for willingness to receive COVID-19 booster vaccine (N\u0026thinsp;=\u0026thinsp;592).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReasons\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe COVID-19 booster vaccine could enhance protection against COVID-19.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e513 (86.66%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe COVID-19 booster vaccine was a social responsibility.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e362 (61.15%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI am aware of the safety and efficacy data of the COVID-19 booster vaccine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e222 (37.50%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe benefits of COVID-19 booster vaccine overweigh the risks.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e180 (30.41%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA policy of free access to COVID-19 booster vaccine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e173 (29.22%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI get introduction from the doctor about the COVID-19 booster vaccine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e128 (21.62%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers have been vaccination.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e77 (13.01%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.6 Reasons for unwillingness to accept COVID-19 booster vaccine\u003c/h2\u003e \u003cp\u003eAmongst the 463 patients who expressed why they resisted COVID-19 booster vaccine, 85.75% (397/463) were concerned that the vaccine would impact cancer treatment and progression, 45.14% (209/463) were concerned that the COVID-19 booster vaccine could cause adverse reactions, and 18.14% (84/463) indicated that the safety and efficacy data on the COVID-19 booster vaccine was lacking (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eReasons for unwillingness to accept COVID-19 booster vaccine (N\u0026thinsp;=\u0026thinsp;463)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReasons\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI was concerned that the COVID-19 booster vaccine would impact cancer treatment and progression.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e397 (85.75%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI was concerned that the COVID-19 booster vaccine could cause adverse reactions.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e209 (45.14%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe safety and efficacy data on the COVID-19 booster vaccine was lacking.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e84 (18.14%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI have received a lot of negative information about the COVID-19 booster vaccine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30 (6.48%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVaccination go against everything I know about health.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (6.05%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI have low risk on COVID-19 Infection.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26 (5.62%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI had a bad experience with vaccinations.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13 (2.81%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eEffective control of the spread of COVID-19 is very critical. On January 3, 2022, a fourth shot of the COVID-19 vaccine was approved by the Ministry of Health of Israel for individuals aged\u0026thinsp;\u0026ge;\u0026thinsp;60 years who have already received the third booster shot and for the immunocompromised ones. On March 29 2022, the US FDA granted emergency use authorization to two vaccines as the fourth shot in individuals aged 50 years and above who have already received the booster shot and in immunocompromised individuals aged 12 years and above. Cancer patients have weakened immune systems, and infection with SARS-CoV-2 may result in very high mortality rates among the patients [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. We conducted a cross-sectional study in China to assess the attitude and acceptance of cancer patients toward getting the COVID-19 booster vaccine before providing cancer patients with the COVID-19 booster vaccine. In this study, 56.11% of the participants were willing to receive the COVID-19 booster vaccine, while 43.89% remained hesitant. The vaccine acceptance rate was slightly lower than that reported in other similar studies. For instance, a 1-week cross-sectional study in China had previously revealed that 88.46% of the 1724 participants were willing to have their children receive the COVID-19 booster vaccine [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In another online cross-sectional survey of healthy workers in Saudi Arabia, 71.1% of the participants expressed their willingness to get a COVID-19 booster vaccine [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Similarly, an online cross-sectional survey of Iraqi adults indicated that 61.1% of the participants were willing to receive the COVID-19 booster vaccine [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The difference in vaccine acceptance rate between our study and others may be attributed to cancer patients being the main subjects of the study. Cancer patients are immunosuppressed compared to normal individuals and are hence more cautious about the COVID-19 booster vaccine. This may be because clinical trials reporting the safety and effectiveness of the COVID-19 booster vaccine in cancer patients are yet to be published. They constantly consider whether the side effects of the COVID-19 booster vaccine will worsen the condition. Therefore, conducting multi-center randomized controlled clinical trials as soon as possible and publishing the results might encourage cancer patients to receive COVID-19 booster vaccine.\u003c/p\u003e \u003cp\u003eThis study also shows that the media is the main trusted source of information, accounting for 52.13%, followed by government agencies, accounting for 51.37%, and friends and family, accounting for 41.80%, consistent with previous findings. For example, a survey in Beirut, Lebanon, revealed that most cancer patients learned about the COVID-19 vaccine through TV, radio broadcasts, and newspaper (89.2%), social media (55.9%), and friends, family, and neighbors (26.1%) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In contrast, a cross-sectional survey performed in the US between 8th and 16th January 2021 revealed that the most common information sources of the COVID-19 vaccine for cancer patients were physicians, clinics and hospitals, followed by disease control and prevention centers and other state health institutions, and then family, friends, and colleagues [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Public skepticism towards vaccines and anti-vaccine movements are extremely common when a new vaccine is being developed. Understanding the relevant channels through which cancer patients receive information about the COVID-19 vaccine is thus extremely vital. Based on our findings, we recommend a further increase in publicity, active guidance from government agencies, and dissemination of vaccine-related data through social media to enable more cancer patients to become aware of the benefits of the booster vaccine.\u003c/p\u003e \u003cp\u003ePatients\u0026rsquo; willingness to receive the vaccine could be influenced by many factors. Amongst the nine independent predictors identified in this study, six promoted vaccine acceptance, while three resulted in vaccine hesitancy. According to relevant reports, smoking is the most obvious risk factor for the progression of COVID-19, which has also been confirmed by other studies. Therefore, cancer patients who often smoke are more fearful of COVID-19 and are more willing to receive the booster vaccine to enhance immunity [\u003cspan additionalcitationids=\"CR30\" citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Consistent with a cross-sectional survey of cancer patients in Tunisia, our multivariate logistic regression revealed that the safety and efficacy of the booster vaccine was an important factor that influenced acceptance [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. A survey in Poland showed that 41.3% of cancer patients were fully aware of the potential value and safety of vaccination [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. During the COVID-19 pandemic, several vaccines, such as the Ad5-nCoV, CoronaVac, and BBIBP-CorV, were approved for the prevention of related diseases in China. The safety and efficacy of these vaccines have been fully validated, and the results have been published in the Lancet and its family of journals [\u003cspan additionalcitationids=\"CR35 CR36 CR37\" citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Herein, many cancer patients were willing to receive the booster shot because they believed it was safe and efficient. This study also demonstrated that the belief that the booster vaccine would increase side effects and affect tumor treatment was the major factor contributing to vaccine hesitancy. In a survey conducted across 3 cancer centers in Tunisia, multivariate logistic regression revealed that cancer patients who believed that the vaccine could interfere with treatment efficacy or impact cancer outcome were more likely to refuse vaccination [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Of note, the side effects of the COVID-19 vaccine on cancer patients remain unclear because of their non-inclusion in most clinical trials and as a population for analysis in subsequent studies [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. A prospective, single-center observational study at the Fox Chase Cancer Center showed that the number of reported adverse events was nearly identical between patients with and without cancer after all participants received two shots of the Pfizer BNT162b2 vaccine. Notably, active cancer treatment had little impact on the adverse event profile [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. A phase I trial revealed that the median neutralizing antibody titer significantly increased one week after the third shot of the BNT162b2 mRNA vaccine in 31 solid tumor patients. However, no improvement was observed in T-cell response, and adverse reactions were mild, which suggested that the vaccine may have immunological benefits in cancer patients undergoing active chemotherapy [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Understanding the effect of the COVID-19 booster vaccine on cancer progression is thus an important premise for promoting vaccination in cancer patients. Moreover, paying for the COVID-19 booster vaccine influenced the participants\u0026rsquo; decision to be vaccinated. This finding was similar to those of an online cross-sectional study in Jordan [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. In Nigeria, most respondents (2496/3076, 81.1%) were unwilling to pay for the COVID-19 vaccine [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. In Pakistan, 33.9% of participants were willing to pay 1000 Pakistani Rupees for the COVID-19 vaccine [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. These results indicate that the vaccine cost is a major obstacle that affects vaccination. The free COVID-19 vaccine in China should thus be continued because the policy is favorable for improving vaccine acceptance among Chinese individuals.\u003c/p\u003e \u003cp\u003eDespite the valuable findings, this study was limited by several factors. First, this was a cross-sectional study, which cannot directly infer causality. Secondly, some participants were elderly, while others had no access to the internet, which hindered them from filling out the survey. In addition, some individuals had no access to social media, especially the elderly and those without internet access. Thirdly, we sent out the survey to cancer patients online, and these populations may find it difficult to solve problems, leading to the phenomenon of estimated responses. Therefore, the sample distribution could have been uneven, leading to limited sample representativeness. The study had a small sample size; thus, future multi-center large cohort studies will be required to validate the findings. The attitude and willingness of cancer patients to receive the booster shot may also change over time as the SARS-CoV-2 mutates and vaccine campaigns continue to grow. The findings obtained may, therefore, not be applicable after some time.\u003c/p\u003e"},{"header":"5 Conclusion","content":"\u003cp\u003eThis study examined the demographic and sociological characteristics of cancer patients and their awareness and attitudes towards COVID-19 booster vaccines and analyzed the independent predictors influencing patient vaccination, so as to better understand why cancer patients are not vaccinated. This study recommends expanding the channels, increasing the publicity, and providing cancer patients with individualized treatment options after adequate risk assessment to allow more cancer patients to benefit from the COVID-19 booster vaccine. Moreover, this study recommends developing specific COVID-19 vaccines for cancer patients based on their pathogenic characteristics to improve vaccine safety and efficacy. That is to say, the governments need to provide strong support and researchers attach great importance to developing specific COVID-19 vaccines for cancer patients. This study recommends developing healthcare policies appropriate for cancer patients to facilitate their acceptance of vaccines, such as publishing the safety and effectiveness of vaccines, providing individualized treatment options after adequate risk assessment and developing specific COVID-19 vaccines suitable for cancer patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u003c/strong\u003e The authors have no conflict of interests related to this publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement:\u003c/strong\u003e This work was supported in part by the National Natural Science Foundation of China (Nos. 82030117 and 82074203).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and Informed consent:\u003c/strong\u003e The analysis was approved by the Ethics Committee, which mainly came from the following two organizations: the first was Chaohu Hospital of Anhui Medical University, with the approval number of KYXM-20210501;\u0026nbsp;The First Affiliated Hospital of Naval Medical University (CHEC2013-119).\u0026nbsp;In the analysis, all the respondents fully grasped the objectives and procedures of the analysis, and also signed an oral informed consent.\u0026nbsp;All procedures in the study were performed in accordance with the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u0026nbsp;\u003c/strong\u003eJH, and MY designed the study. MY, PW, MW and SQZ performed the study and their analyses. MY, QY, YBM and XWX, were responsible for data collection. JH and QMZ performed data analyses. All authors participated in data interpretation, manuscript review and writing. PW and JH were responsible for preparation of the Tables and Figure. All authors contributed to the scientific discussion of the data and of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u0026nbsp;\u003c/strong\u003eThis study acknowledges the contributions of all participant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHas data associated with your study been deposited into a publicly available repository?\u003c/p\u003e\n\u003cp\u003eNo.\u003c/p\u003e\n\u003cp\u003eHas data associated with your study been deposited into a publicly available repository?\u003c/p\u003e\n\u003cp\u003eData will be made available on request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. COVID-19 weekly epidemiological update. 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A national survey of COVID-19 vaccine acceptance in Nigeria. Vaccine. 2022;40(33):4726\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTahir MJ, Saqlain M, Tariq W, Waheed S, Tan SHS, Nasir SI, Ullah I, Ahmed A. Population preferences and attitudes towards COVID-19 vaccination: a cross-sectional study from Pakistan. BMC Public Health. 2021;21(1):1759.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"COVID-19 booster vaccine, cancer patients, cross-sectional study, Attitude, Vaccine Acceptance","lastPublishedDoi":"10.21203/rs.3.rs-4240784/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4240784/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThe 2019 novel coronavirus is still rapidly mutating and spreading worldwide, posing a great global health challenge, especially vulnerable groups, including cancer patients. Studies comparing the clinical outcomes of cancer patients receiving or not receiving the 2019 coronavirus disease (COVID-19) vaccines have not yet shown significant benefits. Therefore, this study mainly focused on the attitudes and willingness of cancer patients toward COVID-19 booster vaccines and to distinguish independent predictors that may impact the vaccination of cancer patients.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAn online cross-sectional study was conducted between July 1 2022 and January 1 2023 in China. Patients were selected using a convenience sampling method, and a self-reporting questionnaire was developed based on a literature review to evaluate the attitude of cancer patients towards the intensive use of COVID-19 vaccines and the willingness of patients to accept the COVID-19 vaccine. Independent predictors associated with accepting a COVID-19 booster vaccine were determined through multivariate logistic regression.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 1055 participants were included in this study. The vaccine acceptance rate was 56.11% (592/1055), while the hesitancy rate was 43.89% (463/1055). Frequent smoking, those who had received two doses of the COVID-19 vaccine, belief that the COVID-19 booster vaccine was necessary, belief that the COVID-19 booster vaccine was safe and effective, willingness to pay for the COVID-19 booster vaccine, and recommendation of COVID-19 booster vaccine by friends and family were contributing factors for vaccine acceptance.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThis study recommends developing healthcare policies appropriate for cancer patients to facilitate their acceptance of vaccines, such as publishing the safety and effectiveness of vaccines, providing individualized treatment options after adequate risk assessment and developing specific COVID-19 vaccines suitable for cancer patients.\u003c/p\u003e","manuscriptTitle":"A survey on the attitude and willingness of Chinese cancer patients toward a COVID-19 booster vaccine","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-19 18:47:05","doi":"10.21203/rs.3.rs-4240784/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"11417797-de3d-4eb8-9bb2-df565b5f0834","owner":[],"postedDate":"April 19th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-04-19T18:47:58+00:00","versionOfRecord":{"articleIdentity":"rs-4240784","link":"https://doi.org/10.1016/j.heliyon.2024.e26869","journal":{"identity":"heliyon","isVorOnly":true,"title":"Heliyon"},"publishedOn":"2024-02-01 18:47:58","publishedOnDateReadable":"February 1st, 2024"},"versionCreatedAt":"2024-04-19 18:47:05","video":"","vorDoi":"10.1016/j.heliyon.2024.e26869","vorDoiUrl":"https://doi.org/10.1016/j.heliyon.2024.e26869","workflowStages":[]},"version":"v1","identity":"rs-4240784","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4240784","identity":"rs-4240784","version":["v1"]},"buildId":"rHA-KDH7Qsr4HCuvH75dn","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}