Aronson Ian David, Bennett Alex S, Ardouin-Guerrier Mary-Andrée, Rivera-Castellar German, Gibson Brent, Santoscoy Samantha, Vargas-Estrella Brittney
Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States.
New York Harm Reduction Educators, New York, NY, United States.
JMIR Form Res. 2022 Mar 23;6(3):e35066. doi: 10.2196/35066.
People who inject drugs are disproportionately impacted by SARS-CoV-2 and COVID-19, yet they do not frequently accept vaccination against SARS-CoV-2 when offered.
This study aimed to explore why people who inject drugs decline free vaccines against SARS-CoV-2 and how barriers to vaccination can potentially be addressed.
We conducted semistructured qualitative interviews with 17 unvaccinated adult persons who inject drugs during August and September 2021 at a New York City syringe service program, where approximately three-fourth of participants identified as Latino (55%) or African American (22%). Interviews lasted roughly 20 minutes. The interview guide examined reasons for declining vaccination, participants' understanding of COVID-19 risks, and how messages could be developed to encourage vaccine uptake among people who inject drugs.
Participants acknowledged that they faced increased risk from SARS-CoV-2 owing to their injection drug use but feared that long-term substance use may have weakened their health, making them especially vulnerable to side effects. Fears of possible side effects, compounded by widespread medical mistrust and questions about the overall value of vaccination contributed to marked ambivalence among our sample. The desire to protect children and older family members emerged as key potential facilitators of vaccination.
Community-developed messages are needed in outreach efforts to explain the importance of vaccination, including the far greater dangers of COVID-19 compared to possible unintended side effects. Messages that emphasize vaccines' ability to prevent inadvertently infecting loved ones, may help increase uptake. Community-focused messaging strategies, such as those used to increase HIV and hepatitis C virus testing and overdose prevention among people who inject drugs, may prove similarly effective.
注射毒品者受严重急性呼吸综合征冠状病毒2（SARS-CoV-2）和冠状病毒病（COVID-19）的影响尤为严重，但在提供针对SARS-CoV-2的疫苗接种时，他们并不经常接受。
本研究旨在探讨注射毒品者拒绝免费SARS-CoV-2疫苗的原因，以及如何可能解决疫苗接种的障碍。
2021年8月至9月，我们在纽约市的一个注射器服务项目中，对17名未接种疫苗的注射毒品成年者进行了半结构化定性访谈，其中约四分之三的参与者为拉丁裔（55%）或非裔美国人（22%）。访谈持续约20分钟。访谈指南考察了拒绝接种疫苗的原因、参与者对COVID-19风险的理解，以及如何制定信息以鼓励注射毒品者接种疫苗。
参与者承认，由于他们注射毒品，他们面临SARS-CoV-2带来更大的风险，但担心长期使用毒品可能损害了他们的健康，使他们特别容易出现副作用。对可能出现的副作用的恐惧，再加上普遍存在的对医疗的不信任以及对疫苗接种总体价值的质疑，导致我们样本中的人明显矛盾。保护儿童和年长家庭成员的愿望成为疫苗接种的关键潜在促进因素。
在外展工作中需要社区制定的信息来解释疫苗接种的重要性，包括与可能的意外副作用相比，COVID-19的危险要大得多。强调疫苗能够防止无意中感染亲人的信息，可能有助于提高接种率。以社区为重点的信息传播策略，如用于增加注射毒品者中艾滋病毒和丙型肝炎病毒检测以及过量用药预防的策略，可能同样有效。
