SARS-CoV-2 vaccine hesitancy in patients with heart failure: relationship with patient characteristics and pre-pandemic quality of life – a cohort study

Filip Sawczak; Agata Kukfisz; Maria Cierzniak; Alicja Szubarga; Aleksandra Soloch; Anita Balewska; Magdalena Szczechla; Helena Krysztofiak; Katarzyna Przytarska; Magdalena Dudek; Izabella Uchmanowicz; Ewa Straburzyńska-Migaj; Marta Kałużna-Oleksy

doi:10.20883/medical.e883

Authors

Filip Sawczak 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0003-3449-8751
Agata Kukfisz 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0001-9424-8004
Maria Cierzniak 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0002-1881-5086
Alicja Szubarga 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0002-6215-7148
Aleksandra Soloch 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0002-7410-190X
Anita Balewska 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0001-7472-478X
Magdalena Szczechla 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0002-7307-4460
Helena Krysztofiak Department of Cardiology, University Hospital in Opole, Poland https://orcid.org/0000-0003-0748-9059
Katarzyna Przytarska 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0001-6985-3640
Magdalena Dudek 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0001-6550-6182
Izabella Uchmanowicz Faculty of Health Sciences, Wroclaw Medical University, Poland https://orcid.org/0000-0001-5452-0210
Ewa Straburzyńska-Migaj 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0002-0545-3370
Marta Kałużna-Oleksy 1st Department of Cardiology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0003-4048-6247

DOI:

https://doi.org/10.20883/medical.e883

Keywords:

COVID-19, quality of life, heart failure, vaccination, vaccination hesitancy, cardiovascular disease, age

Abstract

Heart failure (HF) patients are vulnerable to a complicated course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This research analysed the relationship between the decision not to be immunised against SARS-CoV-2, clinical and epidemiological factors, and the pre-pandemic health-related quality of life (HRQoL) of HF patients. Before the onset of the SARS-CoV-2 pandemic, hospitalised HF patients were enrolled as a prospective cohort and interviewed using the World Health Organization's Quality of Life Brief Version questionnaire. On October 30, 2021, the immunisation status was verified. The association of vaccination hesitancy with epidemiological and clinical parameters and pre-pandemic questionnaire results was tested. Subsequently, independence from confounding factors such as age, sex, the New York Heart Association (NYHA) scale, and left ventricular ejection fraction (LVEF) was analyzed. Among the 136 included patients, 77.9% were vaccinated. Unvaccinated patients were younger (51.2±13.2 vs 56.6±10.3; p = 0.018) and more frequently had non-ischaemic aetiology of HF (73.3% vs 46.7%; p=0.013). It was significant after adjustment for age, sex, NYHA class, and LVEF. There was no association of overall HRQoL or domain scores with vaccination status. Younger age as a factor associated with vaccine avoidance in this population is consistent with data from the general population despite higher exposure to the severe course of the disease.

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