Shea Lindsay, Cooper Dylan, Ventimiglia Jonas, Frisbie Shelby, Carlton Conner, Song Wei, Salzer Mark, Lee Brian, Hotez Emily, Vanness David J
AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States.
College of Public Health, Temple University, Philadelphia, PA, United States.
JMIR Public Health Surveill. 2024 Aug 28;10:e51054. doi: 10.2196/51054.
The autistic population is rapidly increasing; meanwhile, autistic adults face disproportionate risks for adverse COVID-19 outcomes. Limited research indicates that autistic individuals have been accepting of initial vaccination, but research has yet to document this population's perceptions and acceptance of COVID-19 boosters.
This study aims to identify person-level and community characteristics associated with COVID-19 vaccination and booster acceptance among autistic adults, along with self-reported reasons for their stated preferences. Understanding this information is crucial in supporting this vulnerable population given evolving booster guidelines and the ending of the public health emergency for the COVID-19 pandemic.
Data are from a survey conducted in Pennsylvania from April 11 to September 12, 2022. Demographic characteristics, COVID-19 experiences, and COVID-19 vaccine decisions were compared across vaccination status groups. Chi-square analyses and 1-way ANOVA were conducted to test for significant differences. Vaccination reasons were ranked by frequency; co-occurrence was identified using phi coefficient correlation plots.
Most autistic adults (193/266, 72.6%) intended to receive or received the vaccine and booster, 15% (40/266) did not receive or intend to receive any vaccine, and 12.4% (33/266) received or intended to receive the initial dose but were hesitant to accept booster doses. Reasons for vaccine acceptance or hesitancy varied by demographic factors and COVID-19 experiences. The most significant were previously contracting COVID-19, desire to access information about COVID-19, and discomfort with others not wearing a mask (all P=.001). County-level factors, including population density (P=.02) and percentage of the county that voted for President Biden (P=.001) were also significantly associated with differing vaccination acceptance levels. Reasons for accepting the initial COVID-19 vaccine differed among those who were or were not hesitant to accept a booster. Those who accepted a booster were more likely to endorse protecting others and trusting the vaccine as the basis for their acceptance, whereas those who were hesitant about the booster indicated that their initial vaccine acceptance came from encouragement from someone they trusted. Among the minority of those hesitant to any vaccination, believing that the vaccine was unsafe and would make them feel unwell were the most often reported reasons.
Intention to receive or receiving the COVID-19 vaccination and booster was higher among autistic adults than the population that received vaccines in Pennsylvania. Autistic individuals who accepted vaccines prioritized protecting others, while autistic individuals who were vaccine hesitant had safety concerns about vaccines. These findings inform public health opportunities and strategies to further increase vaccination and booster rates among generally accepting autistic adults, to better support the already strained autism services and support system landscape. Vaccination uptake could be improved by leveraging passive information diffusion to combat vaccination misinformation among those not actively seeking COVID-19 information to better alleviate safety concerns.
自闭症患者群体正在迅速增加；与此同时，成年自闭症患者面临着更高的感染新冠病毒不良后果风险。有限的研究表明，自闭症患者对初始疫苗接种持接受态度，但尚未有研究记录该群体对新冠病毒加强针的认知和接受情况。
本研究旨在确定与成年自闭症患者接种新冠疫苗和加强针相关的个人层面和社区特征，以及他们自我报告的偏好原因。鉴于不断变化的加强针指南以及新冠疫情公共卫生紧急状态的结束，了解这些信息对于支持这一弱势群体至关重要。
数据来自2022年4月11日至9月12日在宾夕法尼亚州进行的一项调查。比较了不同疫苗接种状态组的人口统计学特征、新冠病毒感染经历和新冠疫苗接种决定。进行卡方分析和单因素方差分析以检验显著差异。按频率对接种疫苗的原因进行排序；使用phi系数相关图确定共现情况。
大多数成年自闭症患者（193/266，72.6%）打算接种或已接种疫苗和加强针，15%（40/266）未接种或不打算接种任何疫苗，12.4%（33/266）接种或打算接种首剂疫苗但对接受加强针犹豫不决。疫苗接种接受或犹豫的原因因人口统计学因素和新冠病毒感染经历而异。最显著的因素是先前感染过新冠病毒、希望获取有关新冠病毒的信息以及对他人不戴口罩感到不适（所有P = 0.001）。县级因素，包括人口密度（P = 0.02）和该县投票给拜登总统的百分比（P = 0.001）也与不同的疫苗接种接受水平显著相关。接受首剂新冠疫苗的原因在对加强针犹豫或不犹豫的人群中有所不同。接受加强针的人更有可能认可保护他人和信任疫苗是他们接受接种的基础，而对加强针犹豫的人表示他们最初接受疫苗是来自他们信任的人的鼓励。在少数对任何疫苗接种都犹豫的人中，最常报告的原因是认为疫苗不安全且会让他们感觉不适。
成年自闭症患者接种新冠疫苗和加强针的意愿高于宾夕法尼亚州接种疫苗的总体人群。接受疫苗的自闭症患者将保护他人放在首位，而对疫苗犹豫的自闭症患者对疫苗存在安全担忧。这些发现为公共卫生机会和策略提供了信息，以进一步提高普遍接受疫苗的成年自闭症患者的疫苗接种率和加强针接种率，更好地支持本已紧张的自闭症服务和支持系统。通过利用被动信息传播来对抗那些未积极寻求新冠病毒信息的人群中的疫苗接种错误信息，以更好地缓解安全担忧，从而提高疫苗接种率。
