Fernandez Jessica R, Richmond Jennifer, Strassle Paula D, Cunningham-Erves Jennifer, Forde Allana T
Division of Intramural Research, National Institute On Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
J Racial Ethn Health Disparities. 2024 Aug 2. doi: 10.1007/s40615-024-02096-9.
County-level barriers (sociodemographic barriers, limited healthcare system resources, healthcare accessibility barriers, irregular healthcare seeking behaviors, low vaccination history) may impact individuals' reasons for receiving the COVID-19 vaccine.
This study linked data from REACH-US (Race-Related Experiences Associated with COVID-19 and Health in the United States), a nationally representative, online survey of 5475 adults living in the U.S (January-March 2021) to county-level barriers in the COVID-19 Vaccine Coverage Index. County-level vaccination barriers were measured using the COVID-19 Vaccine Coverage Index. Participants reported why they would or would not receive the COVID-19 vaccine in an open-ended item and their responses were coded using thematic analysis. Descriptive statistics and chi-square tests assessed whether reasons for COVID-19 vaccination intentions varied by county-level barriers and whether these distributions varied across racial/ethnic groups.
Thematic analysis revealed twelve themes in participants' reasons why they would or would not receive the COVID-19 vaccine. Themes of societal responsibility (9.8% versus 7.7%), desire to return to normal (8.1% versus 4.7%), and trust in science/healthcare/government (7.7% versus 5.1%) were more frequently reported in counties with low/medium barriers (versus high/very high) (p-values < 0.05). Concerns of COVID-19 vaccine side effects/safety/development (25.3% versus 27.9%) and concerns of access/costs/availability/convenience (1.9% versus 3.6%) were less frequently reported in counties with low/medium barriers (versus high/very high) (p-values < 0.05). Trends in the prevalence of these themes varied across racial/ethnic groups (p-values < 0.05).
Future pandemic responses should consider potential ways county-level barriers shape reasons for COVID-19 vaccination.
县级障碍（社会人口学障碍、医疗系统资源有限、医疗可及性障碍、不规律的就医行为、低疫苗接种史）可能会影响个人接种新冠疫苗的原因。
本研究将来自REACH-US（美国与新冠疫情及健康相关的种族经历）的数据与新冠疫苗接种覆盖指数中的县级障碍相联系。REACH-US是一项对5475名居住在美国的成年人进行的具有全国代表性的在线调查（2021年1月至3月）。县级疫苗接种障碍通过新冠疫苗接种覆盖指数来衡量。参与者在一个开放式问题中报告了他们接种或不接种新冠疫苗的原因，并使用主题分析法对他们的回答进行编码。描述性统计和卡方检验评估了新冠疫苗接种意愿的原因是否因县级障碍而异，以及这些分布在不同种族/族裔群体中是否存在差异。
主题分析揭示了参与者接种或不接种新冠疫苗的原因中的12个主题。在障碍程度低/中等（与高/非常高相比）的县，社会责任主题（9.8%对7.7%）、恢复正常的愿望主题（8.1%对4.7%）以及对科学/医疗保健/政府的信任主题（7.7%对5.1%）的报告频率更高（p值<0.05）。在障碍程度低/中等（与高/非常高相比）的县，对新冠疫苗副作用/安全性/研发的担忧主题（25.3%对27.9%）以及对可及性/成本/可获得性/便利性的担忧主题（1.9%对3.6%）的报告频率较低（p值<0.05）。这些主题的流行趋势在不同种族/族裔群体中有所不同（p值<0.05）。
未来应对疫情时应考虑县级障碍影响新冠疫苗接种原因的潜在方式。
