Health Literacy and COVID-19 Vaccination among Cancer Patients in Northeastern Thailand: A Cross-Sectional Study

Document Type : Research Articles


1 Master of public health program, Faculty of Public Health, Khon Kaen University, Thailand.

2 Faculty of Public Health, Khon Kaen University, Thailand.

3 ASEAN Cancer Epidemiology and Prevention Research Group, Thailand.


Objective: This study aimed to explore factors associated with COVID-19 vaccine uptake among patients with cancer in northeastern Thailand. Methods: A cross-sectional study was conducted in northeastern Thailand between December 29th, 2022 and January 31st, 2023. A community-based, multistage sampling method was used to select patients with any medically diagnosed cancer. An interview form was developed to assess patient sociodemographic factors, health literacy, and COVID-19 vaccination status. Multivariable logistic regression analysis was used to identify the factors associated with COVID-19 vaccination status. Results: Of the 449 participants, 368 (81.96%) had received at least two doses of a COVID-19 vaccine. The multivariable analysis revealed that factors associated with COVID-19 vaccination among cancer patients included: 1) health literacy (excellent: adjusted odd ratio (ORAdj) = 7.23; 95% confidence interval (CI): 2.11–24.71, p = 0.002); sufficient: ORAdj = 6.03; 95% CI: 2.00–18.24, p = 0.001); problematic: ORAdj = 3.88; 95% CI:1.37–11.00, p = 0.011); 2) marital status (ORAdj = 2.90; 95% CI: 1.37–6.14, p = 0.005); 3) cancer treatment at a general hospital (ORAdj = 2.50; 95% CI: 1.25–5.00, p = 0.010); and 4) history of laboratory-confirmed COVID-19 infection (ORAdj = 2.37; 95% CI:1.19–4.71, p = 0.014). Conclusions: The strongest predictor of receiving COVID-19 vaccines was health literacy, which enhances healthcare provider awareness of communicable disease prevention and control for patients with cancer as well as counselling and educating to improve their health literacy. It could influent a higher rate of vaccine uptake among patients with cancer.


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