Scoping the barriers to influenza and pneumococcal vaccinations from the perspectives of patients with cancer: is there a role for the pharmacist?

Abstract

Background: Routine immunisation for influenza and pneumococcal disease has the potential to reduce morbidity and mortality inpatients with cancer. Aim: This scoping review aims to determine barriers to influenza and pneumococcal vaccinations from the perspective of patients with cancer and to discuss the potential role of the pharmacist in impacting these barriers. Design: A systematic search of seven databases, including MEDLINE (Ovid), Cochrane Library, Informit (health), PubMed, and CINAHL (complete), from database inception to 6 June 2023 was conducted. Search terms included: ’cancer’, ’vaccination’, ’influenza’, ’pneumococcal’, and ’barrier’. Articles published in English that describe barriers to receiving vaccinations from the perspectives of patients with cancers were included. Barriers were thematically analysed. Results: Twenty-five articles met the inclusion criteria. Barriers identified in the literature were analysed into three key themes: healthcare professionals, patients, and healthcare system barriers. A key healthcare professional barrier was lack of recommendations from the treating oncologist or haematologist. Patient barriers included lack of information about the indication for vaccination as part of patients’ cancer treatment and fear of side effects. Access to vaccination services was reported as a healthcare system barrier. Conclusion: This scoping review highlights the significant barriers to influenza and pneumococcal vaccination according to patients with cancer. Healthcare professionals, patients, and health systems were identified as key barriers. Enablers to improve vaccination rates include patient education, increased healthcare professional vaccine recommendations, and improved access. Although pharmacists have a potential role to play in addressing these barriers, the feasibility and impact of their involvement requires further research.