了解塞拉利昂弗里敦艾滋病毒感染者对新冠疫苗的接种情况及犹豫态度：一项横断面研究。

Understanding COVID-19 Vaccine Uptake and Hesitancy Among People With HIV in Freetown, Sierra Leone: A Cross-sectional Study.

作者信息

Cummings Peterlyn E, Lakoh Sulaiman, Yendewa Sahr A, Massaquoi Samuel P E, James Peter B, Sahr Foday, Deen Gibrilla F, Gevao Pelema, Yendewa George A

机构信息

College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.

Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone.

出版信息

medRxiv. 2023 May 16:2023.05.11.23289882. doi: 10.1101/2023.05.11.23289882.

DOI:10.1101/2023.05.11.23289882

PMID:37292603

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10246027/

Abstract

OBJECTIVES

People living with HIV (PWH) are at increased risk of COVID-19 related morbidity and mortality, yet less is known about COVID-19 vaccination uptake and hesitancy, especially in sub-Saharan Africa. We aimed to evaluate COVID-19 vaccine uptake and hesitancy among PWH in Sierra Leone.

METHODS

We conducted a cross-sectional study in a convenience sample of PWH in routine care at Connaught Hospital in Freetown, Sierra Leone from April through June 2022. We collected sociodemographic and health-related data. We used the VAX Scale, a validated instrument to assess attitudes towards COVID-19 vaccination. From the responses, we constructed hesitancy (VAX) scores, with higher scores implying negative attitudes towards vaccination. We used generalized linear models to identify factors associated with vaccine hesitancy.

RESULTS

A total of 490 PWH were enrolled (71.4% female, median age 38 years, median CD4 count 412 cells/mm, 83.9% virologically suppressed). About 17.3% had received at least one dose of a COVID-19 vaccine. The mean VAX score was 43.14 ± 7.05, corresponding to 59.9% participants classified as vaccine hesitant. Preference for natural immunity (65.8%) and concerns about commercial profiteering (64.4%) were the commonest reasons for hesitancy, followed by mistrust of vaccine benefits (61.4%) and worries about future side effects (48.0%). In adjusted regression analysis, being Muslim (β = 2.563, p < 0.001) and residence in urban areas (β = 1.709, p = 0.010) were associated with greater vaccine hesitancy, while having tested ever for COVID-19 was associated with lesser vaccine hesitancy (β = -3.417, p = 0.027).

CONCLUSION

We observed a low COVID-19 vaccine uptake and high hesitancy among PWH in Sierra Leone. Our findings underscore the need to address vaccine hesitancy as a critical element of efforts to boost COVID-19 vaccine uptake among this population in Sierra Leone.

摘要

目的

人类免疫缺陷病毒感染者（PWH）感染新型冠状病毒肺炎（COVID-19）后出现相关发病和死亡的风险增加，但对于COVID-19疫苗接种率及犹豫情况了解较少，尤其是在撒哈拉以南非洲地区。我们旨在评估塞拉利昂PWH中COVID-19疫苗的接种率及犹豫情况。

方法

2022年4月至6月，我们在塞拉利昂弗里敦康诺特医院接受常规护理的PWH便利样本中进行了一项横断面研究。我们收集了社会人口学和健康相关数据。我们使用VAX量表，这是一种经过验证的评估对COVID-19疫苗态度的工具。根据回答，我们构建了犹豫（VAX）分数，分数越高表明对疫苗接种的态度越消极。我们使用广义线性模型来确定与疫苗犹豫相关的因素。

结果

共纳入490名PWH（7女，年龄中位数38岁，CD4细胞计数中位数412个/mm，8病毒学抑制）。约17.3%的人至少接种了一剂COVID-19疫苗。VAX平均分数为43.14±7.05，相当于59.9%的参与者被归类为对疫苗犹豫。对自然免疫的偏好（65.8%）和对商业暴利的担忧（64.4%）是犹豫的最常见原因，其次是对疫苗益处的不信任（61.4%）和对未来副作用的担忧（48.0%）。在调整后的回归分析中，穆斯林身份（β=2.563，p<0.001）和居住在城市地区（β=1.709，p=0.010）与更高的疫苗犹豫相关，而曾经进行过COVID-19检测与较低的疫苗犹豫相关（β=-3.417，p=0.027）。