A theory-based study on the vaccination behaviors of breast cancer patients during the COVID-19 pandemic in Taiwan

The study aimed to expand the behavioral analysis of the Theory of Planned Behavior (TPB) to examine COVID-19 vaccine willingness among breast cancer patients. While both the WHO and the U.S. CDC have utilized adapted versions of the Increasing Vaccine Model to study vaccination trends across various populations and industries, limited research has explored vaccine acceptance in specific groups such as breast cancer patients. From May to July 2022, an online cross-sectional study was conducted in Taiwan, coinciding with the initial COVID-19 vaccination rollout. A total of 278 participants were included in the statistical analysis. Structural Equation Modeling (SEM) was employed to assess the conceptual validity of the measurements and test the proposed model. The analysis revealed that the model explained 36.8% of the variance in patients' willingness to receive the COVID19 vaccine and 40.3% of the variance in predicting future vaccination behaviors based on regret following vaccination. Fear of COVID-19 was found to indirectly influence vaccination willingness through shared decision-making, highlighting the importance of discussions between patients and their physicians. Patients who had more opportunities to consult with their doctors were more inclined to get vaccinated. Moreover, fear of COVID-19 enhanced the trust breast cancer patients placed in their physicians. However, decision conflicts and shared decision-making impacted vaccine willingness independently and directly, rather than through the mediating effect of trust in physicians. Furthermore, the study confirmed that patients who hesitated to get vaccinated were more likely to experience regret. These findings provide valuable insights into the behavioral aspects of vaccination among cancer patients, offering strategies to mitigate fear and improve preventive health measures.