The COVID-19 vaccine is the most essential tool for altering the pandemic's trajectory. The pandemic's control is complicated by society's unwillingness to vaccination. The aim of this study was to evaluate the attitudes of patients with hematological malignancies towards vaccination and to determine the relationships between vaccination hesitancy and patient characteristics. The secondary aim was to identify the pandemic-related anxiety level of this patient group and to investigate whether anxiety influences vaccination propensity.

This cross-sectional study was conducted with hematological malignancy patients at Hematology Clinic of the Erciyes University Hospital from Kayseri, Turkey, from 1 May 2021 to 1 December 2021. Patients who (1) were 18 years old or older, (2) voluntarily agreed to take part survey, and (3) could understand and perform the questionnaire met the inclusion criteria. 165 patients with hematological malignancies were included. The questionnaire consisted of three parts. The patients' sociodemographic characteristics, such as age, gender, diagnosis, disease and HSCT status, education level, marital status, location of residence were all asked about in the first section of the study. COVID-19 anxiety situation was evaluated with the Coronavirus Anxiety Scale (CAS). COVID- 19 vaccine attitude was evaluated with the Vaccine Attitudes Review (VAX) Scale.

The median age was 48 (18 - 86) years, 61 (37%) of whom were female. Most of the participants (37%) had been diagnosed with acute myeloid leukemia and were undergoing chemotherapy. In addition, 21% of patients reported having comorbidities. At the time of the survey, 70% of patients had not been infected with COVID-19, whereas 44% had been vaccinated. The mean CAS score was 2.42 (0 - 17). There were 22 (13%) participants with a mean CAS score of ≥9. Half of the participants had a CAS score of 0. The CAS score was higher in females (p= 0.023). Similarly, it was significantly higher in patients who were not in remission for hematological malignancy and who received active chemotherapy (p= 0.010). The mean VAX score was 49.07 ± 8.76 (27-72). Most of the participants (64%) had a neutral attitude towards COVID-19 vaccination. In a survey of 165 patients, 55% said that they were skeptical about vaccination safety, and 58% said that they were concerned about unintended side effects. In addition, 90% expressed moderate concerns about commercial profiteering. Natural immunity was preferred by 30% of the participants. There was no statistically significant correlation between CAS scores and Vaccine Attitudes Review (VAX) Scale.

This study draws attention to the level of anxiety in patients with hematological malignancies of the COVID-19 pandemic. Negative attitudes towards the COVID-19 vaccine are worrisome for at-risk patient groups. We think that patients with hematological malignancies should be informed to eliminate their hesitations about COVID-19 vaccines.