Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, United States.
Centre for Addictive Disorders, Department of Adult Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, 8001, Switzerland.
Alcohol Alcohol. 2024 Sep 21;59(6). doi: 10.1093/alcalc/agae057.
Vaccine hesitancy is increasingly recognized as a health challenge affecting populations worldwide. Given the biological vulnerabilities and structural barriers people who use substances and/or have behavioral addictions face, this systematic review aims to evaluate whether this subpopulation is less prone to adhere to vaccination recommendations.
Electronic searches of published original research were conducted in PubMed, EMBASE, Scopus, and PsycINFO from database inception to December 2022. Our strategy encompassed retrievals regardless of languages and date of publication. Animal studies, abstracts without a full manuscript, and studies which were considered to have lower robustness of scientific evidence were excluded. Outcomes measured were vaccine acceptance, uptake, and adherence. Results were interpreted through a narrative synthesis.
The search yielded 103 retrievals encompassing data collected on 5 576 374 persons who were predominantly residents of Europe (n = 39) and North America (n = 27). Tobacco use, the substance for which many studies were found (n = 91), was significantly associated with poorer vaccine acceptance, uptake and adherence for influenza, COVID-19, human papillomavirus (HPV), and maternal and childhood vaccines. Peri-natal and parental substance use was identified as a risk factor for suboptimal vaccine-related outcomes concerning maternal COVID-19 and childhood vaccines. Finally, people identified as 'using', 'abusing', or 'misusing' drugs or substances may be at decreased odds of all outcomes in various vaccines.
Collectively, the studies identified several groups with statistically significant greater vaccine hesitancy and decreased engagement among whom targeted measures could be beneficial. Timely evidence, especially on behavioral addictions and substances besides tobacco, is lacking, and warrants urgent attention.
疫苗犹豫越来越被认为是影响全球人口的健康挑战。鉴于使用物质和/或有行为成瘾的人面临的生物脆弱性和结构障碍，本系统评价旨在评估该亚人群是否不太倾向于遵守疫苗接种建议。
从数据库建立到 2022 年 12 月，在 PubMed、EMBASE、Scopus 和 PsycINFO 中进行了已发表原始研究的电子检索。我们的策略包括检索无论语言和出版日期如何。排除了动物研究、没有完整手稿的摘要以及被认为科学证据稳健性较低的研究。测量的结果是疫苗接受、接种和依从性。结果通过叙述性综合进行解释。
搜索产生了 103 项检索结果，涵盖了 5576374 名主要来自欧洲（n=39）和北美的人群的数据。许多研究发现（n=91）的烟草使用与流感、COVID-19、人乳头瘤病毒（HPV）和孕产妇及儿童疫苗的疫苗接受、接种和依从性较差显著相关。围产期和父母的物质使用被确定为孕产妇 COVID-19 和儿童疫苗的疫苗相关结果不佳的危险因素。最后，被确定为“使用”、“滥用”或“误用”药物或物质的人在各种疫苗中的所有结果的可能性都较低。
总的来说，这些研究确定了几个统计学上显著疫苗犹豫程度更高且参与度降低的群体，针对这些群体采取有针对性的措施可能会有所裨益。特别是关于行为成瘾和除烟草以外的物质的及时证据，非常缺乏，需要紧急关注。
