Factors influencing influenza vaccine hesitancy among cancer patients: a multicenter cross-sectional study based on the Health Belief Model.

BACKGROUND: Cancer patients often become high-risk groups for influenza due to their immunosuppressed state, and the risk of severe illness after infection significantly increases. However, this group generally has influenza vaccine hesitancy, resulting in an unsatisfactory vaccination rate. This study aimed to investigate the influenza vaccination rate of cancer patients in China, systematically assessed the current situation of vaccine hesitancy, and explored its key influencing factors. METHODS: From April to June 2025, a cross-sectional study design was adopted to conduct a questionnaire survey among cancer patients in six tertiary general hospitals in China. A self-designed structured questionnaire was used to investigate their influenza vaccination rate and the status of vaccine hesitancy. Chi-square test and t-test were used for univariate analysis, and binary logistic regression was employed to identify the independent predictors of vaccine hesitancy. RESULTS: The questionnaires achieved a 91.6% (618/675) valid response rate. Vaccine hesitancy was reported by 491 participants (79.4%). Multivariate regression analysis indicated that higher perceived susceptibility (OR = 0.707, 95% CI: 0.548–0.857) and perceived benefits (OR = 0.635, 95% CI:0.562–0.717) and lower perceived barriers (OR = 0.673, 95% CI:0.585–0.774) provided protection against vaccine hesitation. The key risk factors included a duration of diagnosis of 1–4 years (OR = 2.964, 95% CI:1.449–6.063), reporting no history of influenza infection (OR = 2.336, 95% CI:1.118–4.882), and lack of physician recommendation (OR = 7.522, 95% CI:3.545–15.962). CONCLUSIONS: This study highlights the prominent phenomenon of vaccine hesitancy among Chinese cancer patients. In the future, targeted intervention strategies need to be developed and translated into clinical practice to increase vaccination rates and improve long-term quality of life. TRIAL REGISTRATION: ChiCTR2500098953, registered in Mar, 17th, 2025. Prospective registered.