Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Public Health Rep. 2022 Sep-Oct;137(5):1031-1040. doi: 10.1177/00333549221110299. Epub 2022 Jul 16.
People who inject drugs are a population who are often unengaged with health care services. The objective of this study was to characterize COVID-19 vaccine hesitancy and uptake in a community-based sample of people who inject drugs in Baltimore, Maryland.
The ALIVE study (AIDS Linked to the IntraVenous Experience) in Baltimore is a community-based cohort study of people with a history of injection drug use. From March 2 through June 28, 2021, 346 ALIVE participants completed a survey on substance use, structural determinants of health, and COVID-19 vaccine hesitancy. The exposure of interest was COVID-19 vaccine hesitancy, and the primary outcome was vaccination status as of June 30, 2021. We extracted data on the dates of vaccination from electronic medical records linked to study participants.
The median age of the sample was 60 years; most participants were male (66%) and non-Hispanic Black (87%). Most (55%) trusted the COVID-19 vaccine, and 68% had received ≥1 dose. After age standardization, survey participants were more likely than the Maryland general population to be unvaccinated (prevalence ratio = 1.20; 95% CI, 0.97-1.49; = .10). Participants who somewhat trusted or did not trust the COVID-19 vaccine had 6-fold higher odds of being unvaccinated than participants who trusted the vaccine (odds ratio = 6.30; 95% CI, 3.74-10.60).
Uptake of COVID-19 vaccine among people with a history of injection drug use was high. Attitudes and knowledge about vaccination were important predictors of vaccine uptake. Education and outreach efforts could be effective in reducing hesitancy and increasing vaccination in substance-using populations.
注射毒品者通常不参与医疗保健服务，是一个特殊群体。本研究的目的是描述马里兰州巴尔的摩市一个基于社区的注射毒品者样本中对 COVID-19 疫苗的犹豫和接受情况。
巴尔的摩的 ALIVE 研究（与静脉内经验相关的艾滋病）是一项针对有注射吸毒史人群的基于社区的队列研究。2021 年 3 月 2 日至 6 月 28 日，346 名 ALIVE 参与者完成了一项关于药物使用、健康结构决定因素和 COVID-19 疫苗犹豫的调查。感兴趣的暴露因素是 COVID-19 疫苗犹豫，主要结局是截至 2021 年 6 月 30 日的疫苗接种状况。我们从与研究参与者相关联的电子病历中提取疫苗接种日期的数据。
样本的中位数年龄为 60 岁；大多数参与者为男性（66%）和非西班牙裔黑人（87%）。大多数人（55%）信任 COVID-19 疫苗，68%已接种至少 1 剂。在年龄标准化后，调查参与者未接种疫苗的可能性比马里兰州一般人群高（流行率比=1.20；95%置信区间，0.97-1.49；=.10）。与信任疫苗的参与者相比，有些信任或不信任 COVID-19 疫苗的参与者未接种疫苗的可能性高 6 倍（比值比=6.30；95%置信区间，3.74-10.60）。
有注射毒品史的人群中 COVID-19 疫苗的接种率较高。对疫苗接种的态度和知识是疫苗接种率的重要预测因素。在药物使用人群中，教育和宣传工作可能会有效地减少犹豫情绪，提高疫苗接种率。
