Exploring acceptance of COVID-19 vaccination among breast cancer patients: a qualitative study in a tertiary care hospital in Rawalpindi, Pakistan
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Abstract
Objective: To explore the factors influencing belief formation regarding COVID-19 vaccine acceptance among women diagnosed with breast cancer in Pakistan.
Methods: This exploratory qualitative study, guided by an interpretivist paradigm, was conducted at a tertiary care hospital in Rawalpindi, Pakistan. Semi-structured, in-depth interviews were conducted between December-2021 and March-2022 among adult breast cancer patients receiving active treatment, using typical case sampling. Interviews were audio-recorded with informed consent and continued until data saturation. Transcripts were analysed concurrently using reflexive thematic analysis based on Braun and Clarke’s six-phase framework, with trustworthiness ensured through reflexivity, audit trails, team discussions, and inclusion of verbatim quotations.
Results: Eleven female participants (mean age 49.4±11.3 years) were interviewed. One overarching theme, Belief Formation Regarding COVID-19 Vaccination, emerged, supported by five inter-related themes: psychosocial concerns during the pandemic, cancer- and COVID-19-related beliefs, vaccination experiences, interactions with healthcare providers, and coping and support mechanisms. Vaccine acceptance was shaped by emotional distress following cancer diagnosis, fear of immunosuppression, religious and familial influences, trust in healthcare workers, prior vaccine experiences, and exposure to misinformation and conspiracy beliefs. Supportive healthcare interactions and adaptive coping strategies facilitated acceptance, while financial stress, social isolation, and distrust in authorities contributed to hesitancy.
Conclusion: Beliefs regarding COVID-19 vaccination among breast cancer patients are complex and deeply embedded within psychosocial, cultural, and healthcare contexts. Resilience grounded in faith, family support, trust in healthcare providers, and active coping facilitated acceptance, whereas conspiracy beliefs, distrust of rapid vaccine development, fear of treatment-related immunosuppression, and social isolation contributed to hesitancy.
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