Shrestha Roman, Meyer Jaimie P, Shenoi Sheela, Khati Antoine, Altice Frederick L, Mistler Colleen, Aoun-Barakat Lydia, Virata Michael, Olivares Miriam, Wickersham Jeffrey A
Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA.
Vaccines (Basel). 2022 Mar 10;10(3):424. doi: 10.3390/vaccines10030424.
Introduction: Scaling up vaccination against COVID-19 is central to controlling the COVID-19 epidemic in the United States. Several vaccines are now approved for the prevention of COVID-19, but public concerns over safety and efficacy have heightened distrust and vaccine hesitancy. This is particularly concerning among people with HIV (PWH) who may be vulnerable to more severe COVID-19 disease. Here, we aimed to identify and understand COVID-19 vaccine hesitancy in a sample of PWH in the U.S. Methods: We conducted a cross-sectional online survey among PWH in the U.S. between 6 December 2020 and 8 January 2021. Measures included demographics, participants’ HIV and health-related attributes, COVID-19 history and experiences, COVID-19 vaccine-related concerns, and standardized measures of attitudes towards COVID-19 vaccines. Multivariate linear regression was used to identify factors associated with vaccine hesitancy in this sample. Results: Among the 1030 respondents, most were male (89.7%), White (66.0%), and identified as gay or lesbian (84.5%). Participants’ mean time living with HIV was 17.0 years (standard deviation (SD) = 11.1). The mean score for vaccine hesitancy was 1.5 (SD = 0.5; range: 1−5); 935 participants (90.8%) had a score greater than 1.0, indicating most participants had some degree of vaccine hesitancy. The final multivariate linear regression showed that greater vaccine hesitancy was associated with being Black (b = 0.149, p = 0.005), single (b = 0.070, p = 0.018), politically conservative (b = 0.157, p = 0.010), “anti-vaxxer” (b = 1.791, p < 0.001), concern about side effects (b = 0.226, p < 0.001), concern about safety (b = 0.260, p < 0.001), and being worried that the vaccine will not be effective (b = 0.169, p = 0.008) and they were being experimented on (b = 0.287, p < 0.001). Participants who were male White (b = −0.093, p = 0.008) and university graduates (b = −0.093, p < 0.001) and had a CD4 count of 200 cells/mm3 (b = −0.082, p = 0.048) and a liberal political orientation (b = −0.131, p < 0.001) were associated with lower vaccine hesitancy. Conclusions: Our findings provide important insights regarding COVID-19 vaccine hesitancy among PWH. Further efforts are required to understand how various social, political, and psychological factors contribute to COVID-19 vaccine hesitancy among key populations.
扩大新冠病毒疫苗接种是美国控制新冠疫情的核心。目前有几种疫苗已获批用于预防新冠病毒，但公众对安全性和有效性的担忧加剧了不信任和疫苗犹豫情绪。这在艾滋病毒感染者（PWH）中尤为令人担忧，他们可能更容易感染更严重的新冠疾病。在此，我们旨在识别并了解美国艾滋病毒感染者样本中的新冠病毒疫苗犹豫情况。方法：我们于2020年12月6日至2021年1月8日对美国的艾滋病毒感染者进行了一项横断面在线调查。测量内容包括人口统计学特征、参与者的艾滋病毒及健康相关属性、新冠病毒感染史和经历、与新冠病毒疫苗相关的担忧，以及对新冠病毒疫苗态度的标准化测量。使用多元线性回归来确定该样本中与疫苗犹豫相关的因素。结果：在1030名受访者中，大多数为男性（89.7%）、白人（66.0%），并自我认同为同性恋或双性恋（84.5%）。参与者感染艾滋病毒的平均时长为17.０年（标准差（SD）=11.1）。疫苗犹豫的平均得分为1.5（SD = 0.5；范围：1 - 5）；935名参与者（90.8%）得分高于1.0，表明大多数参与者有一定程度的疫苗犹豫。最终的多元线性回归显示，更高的疫苗犹豫与黑人身份（b = 0.149，p = 0.005）、单身（b = 0.070，p = 0.018）、政治保守（b = 0.157，p = 0.010）、“反疫苗者”（b = 1.791，p < 0.001）、担心副作用（b = 0.226，p < 0.001）、担心安全性（b = 0.260，p < 0.001）、担心疫苗无效（b = 0.169，p = 0.008）以及担心自己成为试验对象（b = 0.287，p < 0.001）相关。男性白人参与者（b = -0.093，p = 0.008）、大学毕业生（b = -0.093，p < 0.001）、CD4细胞计数为200个/立方毫米的参与者（b = -0.082，p = 0.048）以及具有自由政治倾向的参与者（b = -0.131，p < 0.001）与较低的疫苗犹豫相关。结论：我们的研究结果为艾滋病毒感染者中的新冠病毒疫苗犹豫情况提供了重要见解。需要进一步努力去了解各种社会、政治和心理因素如何导致关键人群中的新冠病毒疫苗犹豫。
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