Rheumatology department, Liverpool Hospital, Liverpool, NSW, Australia; University of NSW, Sydney, Australia.
Rheumatology department, Liverpool Hospital, Liverpool, NSW, Australia; University of NSW, Sydney, Australia.
Patient Educ Couns. 2024 Jan;118:107996. doi: 10.1016/j.pec.2023.107996. Epub 2023 Sep 30.
People with autoimmune and inflammatory rheumatic disease (AIIRD) are at an increased risk of morbidity from COVID-19. While COVID-19 vaccination is effective at reducing disease complications, there have been significant levels of vaccine hesitancy in people with AIIRD. We aimed to understand vaccine hesitancy and promote shared decision-making by describing the experiences and perspectives of people with AIIRD who had concerns with COVID-19 vaccinations.
Adults with AIIRD on immunosuppressive medications who expressed concerns regarding the COVID-19 vaccination were purposively sampled until thematic saturation. Individual semi-structured interviews were conducted and analysed using reflexive thematic analysis.
Sixteen adults with an AIIRD were interviewed. Thematic analysis yielded four themes: heightened sense of vulnerability; determining individual suitability; desperate for freedom and relief; deterred by scepticism.
The perspectives of people with AIIRD towards the COVID-19 vaccination were shaped by a sense of vulnerability. The decision-making experience was challenging, resulting from struggles with handling information, dealing with external pressures, and facing negativity.
A collaborative approach, involving close family and friends and avoiding negativity and pressure can improve engagement and support decision-making around COVID-19 vaccination. Clearly addressing potential risks of vaccination may prevent subsequent regret and hesitancy if they arise.
自身免疫性和炎症性风湿病（AIIRD）患者罹患 COVID-19 的发病率增加。虽然 COVID-19 疫苗接种可有效降低疾病并发症，但 AIIRD 患者对疫苗的犹豫程度仍很高。我们旨在通过描述对 COVID-19 疫苗接种有顾虑的 AIIRD 患者的经历和观点，了解疫苗犹豫，并促进共同决策。
从接受免疫抑制药物治疗且对 COVID-19 疫苗接种表示担忧的 AIIRD 成年患者中，有目的地进行抽样，直至达到主题饱和。对参与者进行了个体化半结构式访谈，并使用反思性主题分析进行了分析。
共对 16 名 AIIRD 成年患者进行了访谈。主题分析产生了四个主题：高度脆弱感；确定个体适用性；渴望自由和缓解；对怀疑感到恐惧。
AIIRD 患者对 COVID-19 疫苗接种的看法受到脆弱感的影响。由于在处理信息、应对外部压力和面对消极情绪方面存在困难，决策过程极具挑战性。
采用协作方法，包括密切的家人和朋友，并避免消极和压力，可以提高 COVID-19 疫苗接种的参与度并支持决策。明确解决疫苗接种的潜在风险，如果出现后续的遗憾和犹豫，可能会防止其发生。
