COVID-19 Vaccine Uptake in Patients with Multiple Myeloma and AL Amyloidosis: A Cross-Sectional Observational Study from India.

ABSTRACT

COVID-19 vaccine uptake has been comparable, if not higher, in LMICs (Low- and Middle-Income Countries) than in developed nations. Patients with plasma cell disorders are at a higher risk for developing COVID-19 related morbidity and mortality due to impaired immune responses. We report the outcome of active counselling for COVID-19 vaccines in patients with multiple myeloma (MM) and AL amyloidosis and the reasons for hesitancy in those unvaccinated. This was a cross-sectional, single-centre, observational study enrolling patients who visited the hospital between January 1, 2021 and June 30, 2021. Patients with MM and AL amyloidosis at diagnosis or follow-up were actively counselled by treating oncologists regarding the available COVID-19 vaccines (Covishield and Covaxin) during clinic visits or hospital admission. In the subsequent hospital visits, vaccination details were collected and verified. A structured interview schedule was administered to unvaccinated patients to identify the reasons behind vaccine hesitancy. Association of vaccine acceptance with socio-economic parameters and other disease parameters was studied using Chi-square test. Out of 195 patients, 178 (91%) were included in the study; 17 were lost to follow-up. At least a single dose of vaccine was administered in 86%. 79% received Covishield, whereas 21% received Covaxin. 67% received both vaccine doses. Vaccine-related side effects were mild and no vaccine-related thrombotic events were seen. Three patients died due to COVID-19-related causes, of which two were unvaccinated. The reasons for hesitancy in the 24 unvaccinated patients included 9-poor general health conditions, 8-lack of advice from doctors, 2-fear of side effects, and 2-unavailability of vaccine delivery centres nearby. In comparison to the other studies, we report a higher vaccine uptake which can be attributed to targeted counselling by the treating oncologist and the universal free vaccination programme that is familiar to all Indians.