The Warren Alpert Medical School of Brown University, Providence, Rhode Island; Program in Liberal Medical Education, Brown University, Providence, Rhode Island.
The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Transplant Proc. 2024 Oct;56(8):1861-1869. doi: 10.1016/j.transproceed.2024.08.024. Epub 2024 Sep 2.
Understanding COVID-19 vaccine hesitancy in organ transplant recipients (OTRs) is critical given clear-albeit attenuated-benefits from vaccination.
Adult OTRs were surveyed regarding sociodemographic data, medical history, and vaccine-related values. A novel outcome variable called the Vaccine Acceptance Composite Score (VACS) was built as the average Likert score of seven domains of vaccine confidence. To examine its association with several factors and individual adherence to COVID-19 vaccine recommendations, univariable odds ratios and relative operating characteristic areas under the curve (AUC) values were calculated.
Of 46 OTRs included, 32.6% identified as female, 13.3% as Black, and 6.77% as Hispanic or Latino/a/x. The median age was 58 years old. 93.5% of patients were kidney transplant recipients, and 63.0% previously had COVID-19. Patients were most concerned about COVID-19 vaccine-associated risks (46.3%), its potential effect on allograft (47.6%), and motives of government officials involved with vaccine policy (55.6%). Politically conservative patients were likelier to have lower VACS, whereas those who lived with someone ≥65 years old were likelier to have higher VACS. The VACS was not significantly associated with race, income, religious beliefs, comorbidities, COVID-19 history, or influenza vaccination status. Higher VACS was associated with ≥3 and ≥4 COVID-19 immunizations.
This study highlighted political beliefs and elderly household members as correlates of vaccine acceptance among OTRs. The VACS may be a useful tool to help standardize multifaceted analyses in vaccination-focused behavioral research. In clinical practice, it could help identify individuals and groups at risk for vaccine hesitancy, who may benefit from tailored outreach and educational interventions.
鉴于接种疫苗可带来明显（尽管有所减弱）益处，了解器官移植受者（OTR）对 COVID-19 疫苗的犹豫态度至关重要。
对成年 OTR 进行社会人口统计学数据、病史和疫苗相关价值观调查。构建了一个新的结果变量，称为疫苗接受综合评分（VACS），其平均值为七个疫苗信心领域的李克特评分。为了研究其与多个因素的关联以及个体对 COVID-19 疫苗推荐的遵守情况，计算了单变量优势比和接受者操作特征曲线下的面积（AUC）值。
在纳入的 46 名 OTR 中，32.6%为女性，13.3%为黑人，6.77%为西班牙裔或拉丁裔/人。中位年龄为 58 岁。93.5%的患者为肾移植受者，63.0%的患者以前曾感染过 COVID-19。患者最关心 COVID-19 疫苗相关风险（46.3%）、其对移植物的潜在影响（47.6%）以及参与疫苗政策的政府官员的动机（55.6%）。政治保守的患者 VACS 较低，而与≥65 岁的人同住的患者 VACS 较高。VACS 与种族、收入、宗教信仰、合并症、COVID-19 病史或流感疫苗接种状况无关。较高的 VACS 与≥3 次和≥4 次 COVID-19 免疫接种有关。
本研究强调了政治信仰和老年家庭成员是 OTR 疫苗接受的相关因素。VACS 可能是一种有用的工具，有助于在以疫苗为重点的行为研究中标准化多方面的分析。在临床实践中，它可以帮助识别有疫苗犹豫风险的个体和群体，他们可能受益于有针对性的外展和教育干预。
