了解早期乳腺癌患者新型冠状病毒肺炎疫苗的接种情况，分析影响疫苗接种的因素。

根据纳入及排除标准，入组2021年9月21日至2022年1月6日在北京协和医学院肿瘤医院乳腺门诊治疗的400例早期乳腺癌患者进行回顾性分析。采用匿名问卷调查的方式收集患者的基本资料和新型冠状病毒疫苗接种数据的相关数据。根据患者是否接种新型冠状病毒肺炎疫苗分为疫苗接种组和疫苗犹豫组。问卷内容包括患者基本信息、肿瘤情况、疫苗接种状态、疫苗接种或犹豫的原因。其中年龄、固定收入、基础疾病、区域淋巴结转移、是否接受抗肿瘤治疗均为计数资料，用例数(构成比)表示，单因素分析采用χ²检验。学历和家庭成员数目为等级资料，组间比较采用Mann-Whitney检验。多因素分析采用Logistic回归分析。

400例早期乳腺癌患者中疫苗接种组为77例，疫苗犹豫组为323例，新型冠状病毒肺炎疫苗的接种率为19.3%(77/400)。单因素分析显示，疫苗接种组患者区域淋巴结转移比例为15.6%(12/77)，低于疫苗犹豫组的27.6%(89/323)(χ²＝4.720，P＝0.030)；且该组患者未接受抗肿瘤治疗患者比例为31.2%(24/77)，高于疫苗犹豫组的17.3%(56/323)(χ²＝7.434，P＝0.008)。多因素分析发现，早期乳腺癌患者出现区域淋巴结转移是不愿意接种新型冠状病毒肺炎疫苗的独立危险因素(OR＝2.160, 95%CI：1.230~3.790, P＝0.007)。新型冠状病毒肺炎疫苗接种的主要原因包括国家政策鼓励(72.7%，56/77)、相信疫苗的安全性(63.6%，49/77)和担心感染新型冠状病毒肺炎病毒(59.7%，46/77)。新型冠状病毒肺炎疫苗接种犹豫的主要原因包括担心疫苗影响病情(47.1%，152/323)、担心疫苗不良反应(29.7%，96/323)、肿瘤科医师未推荐(18.9%，61/323)以及网络媒体资料提示术后未满2年不能进行疫苗注射(12.1%，39/323)。

早期乳腺癌患者新型冠状病毒肺炎疫苗接种率较低，尤其是伴有区域淋巴结转移的患者，主要与患者担心疫苗影响病情相关。未来可通过权威媒体及时发布正确的疫苗接种信息，加强对肿瘤科医师的培训等方法，提升这部分患者对新型冠状病毒肺炎疫苗接种的信心，从而提高疫苗接种率。

To investigate the vaccination against COVID-19 in patients with early breast cancer and analyze the influencing factors.

According to the inclusion and exclusion criteria, 400 patients with early breast cancer treated in the breast outpatient clinic of Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from September 21, 2021 to January 6, 2022 were enrolled for a retrospective study. Anonymous questionnaires were used to collect the general data of patients and the data related to COVID-19 vaccination. Patients were divided into vaccination group and vaccine hesitancy group according to whether they received the vaccination or not. The questionnaires included basic information of patients, tumor status, vaccination status, and reasons for vaccination or hesitancy. The count data (age, fixed income, comorbidities, regional lymph node metastasis and antitumor therapy) were presented as cases (%) and compared between two groups by χ² test. The ranked data (education background and number of family members) were compared between two groups by the Mann-Whitney test. Logistic regression analysis was used for multivariate analysis.

Among 400 patients, 77 cases were vaccinated (vaccination group) and 323 cases were not vaccinated (vaccine hesitancy group). The vaccination rate was 19.3% (77/400). Univariate analysis showed that the vaccination group had a significantly lower rate of regional lymph node metastasis compared with the vaccine hesitancy group [15.6% (12/77) vs 27.6% (89/323), χ²=4.720, P=0.030], but with a significantly higher proportion of patients who did not receive antitumor therapy [31.2%(24/77) vs 17.3%(56/323), χ²=7.434, P=0.008]. Multivariate analysis showed that regional lymph node metastasis was an independent risk factor for vaccination hesitation(OR =2.160, 95%CI: 1.230-3.790, P=0.007). The reasons for vaccination willingness were as follow: national policy to encourage vaccination (56/77, 72.7%), belief in the safety of the vaccine (49/77, 63.6%, ) and fear of COVID-19 infection (46/77, 59.7%). The reasons for vaccination hesitation were as follow: concern about effect of vaccination on breast cancer progression (152/323, 47.1%), concern about adverse events of vaccination (96/323, 29.7%), no recommendation from the oncologists (61/323, 18.9%) and internet rumors about no vaccination within 2 years after operation (39/323, 12.1%).

The early breast cancer patients, especially the patients with regional lymph node metastasis, have a low COVID-19 vaccination rate, which is mainly due to patients’ concern about the effect of vaccination on breast cancer. Future intervention, which include timely and accurate information release by authoritative media and training for oncologists in order to enhance the confidence of patients in COVID-19 vaccination.