Weierbach Florence M, Adkins Fletcher Rebecca, Luffman Ingrid E, Meyer Cynthia, Keener Janet M, Ahuja Manik, Mamudu Hadii M
East Tennesee State University.
East Tennessee State University.
J Appalach Health. 2023 Dec 1;5(3):71-84. doi: 10.13023/jah.0503.06. eCollection 2023.
The newly emergent COVID-19 virus reached pandemic levels in March 2020. By the middle of August 2020, there were over 1 million deaths attributed to COVID-19 in the U.S., with those in rural areas outpacing urban counterparts. Prior to emergency approval of the Pfizer, Moderna and Johnson & Johnson vaccine formulations, mitigation efforts addressing individual behavior were challenging. However, even with the entrance of these three new vaccines, herd immunity was not achieved in rural areas, as vaccine uptake remained low there. Although there has since been an abundance of COVID-19-related research addressing health literacy, vaccine hesitancy and overall medical mistrust, few of these studies focus on Appalachia.
This study identifies barriers and facilitators to adherence with COVID-19 mitigation, focusing specifically on vaccine hesitancy in South Central Appalachia.
A secondary data study was conducted with a subset of Appalachian residents from the COVID-19 Public Health survey. Participants were grouped by county using ARC economic county designations for analysis. The dependent variable, vaccine hesitancy, was explored in relation to five categories of independent variable: (1) demographics (with four conceptual areas); (2) belief; (3) action; (4) medical mistrust; and (5) health literacy.
Findings indicate vaccine hesitancy attributes include beliefs addressing COVID-19 threat, overstatement of severity of illness, risk of vaccines, vaccine safety information not present from manufacturer, and independent decision to vaccinate. Findings from this study are comparable to HPV vaccine studies in Appalachia.
As interventions are developed for Appalachia, it is paramount to focus vaccine administration at the individual and population level.
新出现的新冠病毒在2020年3月达到了大流行程度。到2020年8月中旬，美国有超过100万人死于新冠病毒，农村地区的死亡人数超过了城市地区。在辉瑞、莫德纳和强生疫苗配方获得紧急批准之前，针对个人行为的缓解措施颇具挑战性。然而，即使这三种新疫苗问世，农村地区仍未实现群体免疫，因为那里的疫苗接种率仍然很低。尽管此后有大量关于新冠病毒的研究涉及健康素养、疫苗犹豫和对医疗的总体不信任，但这些研究很少关注阿巴拉契亚地区。
本研究确定了新冠病毒缓解措施依从性的障碍和促进因素，特别关注中阿巴拉契亚地区的疫苗犹豫问题。
对新冠病毒公共卫生调查中阿巴拉契亚居民的一个子集进行了二次数据研究。使用ARC经济县指定对参与者按县进行分组以进行分析。将因变量疫苗犹豫与五类自变量相关联进行探讨：(1)人口统计学（有四个概念领域）；(2)信念；(3)行为；(4)对医疗的不信任；以及(5)健康素养。
研究结果表明，疫苗犹豫的归因包括对新冠病毒威胁的信念、对疾病严重程度的夸大、疫苗风险、制造商未提供疫苗安全信息以及自主决定接种疫苗。本研究的结果与阿巴拉契亚地区的人乳头瘤病毒疫苗研究结果相当。
在为阿巴拉契亚地区制定干预措施时，将疫苗接种工作重点放在个人和群体层面至关重要。
