D'Souza Gail Carmen, Yingst Jessica M, Krebs Nicolle M, Bordner Candace, Allen Sophia I, Calo William A, Hobkirk Andrea L, Foulds Jonathan
Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State University, Hershey, Pennsylvania, United States of America.
Penn State Cancer Institute, Hershey, Pennsylvania, United States of America.
PLoS One. 2024 Dec 12;19(12):e0309780. doi: 10.1371/journal.pone.0309780. eCollection 2024.
The coronavirus disease (COVID-19) pandemic has spread in the US with more than 100 million human infections and a million deaths since March 2020. A population of concern are high-risk individuals such as adults who are tobacco users, since COVID-19 is a respiratory disease that affects the lungs. Although 79% of the US population ≥ 18 years of age have completed the primary COVID-19 vaccine series; it is imperative to understand the factors associated with receiving or declining the COVID-19 vaccine among high-risk populations to improve vaccination rates. Guided by the diffusion of innovations (DOI) theory, this study identified factors associated with COVID-19 vaccination and the impact on COVID-19 vaccine uptake in adults who use tobacco. We conducted a cross-sectional study using a sample of Pennsylvanian adult tobacco users by sending a unique survey link to 4,081 email addresses in April 2022. Participants were asked about tobacco use, COVID-19 vaccination status, and reasons for receiving/declining the COVID-19 vaccine. Participants (n = 157) were 75% female, 96% White, 74% current tobacco users, and had a mean age of 50.1 (SD = 10.8) years. Nearly 78% (n = 119) received at least one dose of the COVID-19 vaccine (primary series). We categorized all vaccinated tobacco users into adopter categories of the DOI theory; innovators (10%), early adopters (14%), early majority (33%), late majority (11%), and laggards (32%). The major reason that prompted participants to get the COVID-19 vaccine was to ensure they were well protected against COVID-19 infection (77%). Additionally, the only reason for receiving the vaccine that significantly predicted early vaccine uptake (being an innovator or early adopter) was "to loosen restrictions on mask mandates and social/physical distancing" (p = 0.0180). Among the 22% that did not receive a COVID-19 vaccine, the most common major reason they declined the vaccine was because they felt politics played a big role in the vaccine development process (94%). Our findings suggest that major f actors that influenced why adult tobacco users would receive or decline the COVID-19 vaccine included infection control mandates, protection from the COVID-19 infection, and politics. Investigating these factors can help public health professionals design or develop future vaccination programs for high-risk populations in order to scale up vaccination rates.
自2020年3月以来，冠状病毒病（COVID-19）大流行已在美国蔓延，造成超过1亿人感染，100万人死亡。令人担忧的人群包括高风险个体，如吸烟的成年人，因为COVID-19是一种影响肺部的呼吸道疾病。尽管美国79%的18岁及以上人群已完成COVID-19疫苗基础免疫接种系列；但了解高风险人群中接受或拒绝接种COVID-19疫苗的相关因素对于提高疫苗接种率至关重要。在创新扩散（DOI）理论的指导下，本研究确定了与COVID-19疫苗接种相关的因素以及对吸烟成年人COVID-19疫苗接种率的影响。我们于2022年4月向宾夕法尼亚州成年烟草使用者样本发送了一个独特的调查链接，进行了一项横断面研究。参与者被问及烟草使用情况、COVID-19疫苗接种状况以及接受/拒绝接种COVID-19疫苗的原因。参与者（n = 157）中75%为女性，96%为白人，74%为当前吸烟者，平均年龄为50.1（标准差 = 10.8）岁。近78%（n = 119）的人接种了至少一剂COVID-19疫苗（基础免疫接种系列）。我们将所有接种疫苗的烟草使用者按照DOI理论的采用者类别进行了分类；创新者（10%）、早期采用者（14%）、早期多数（33%）、晚期多数（11%）和落后者（32%）。促使参与者接种COVID-19疫苗的主要原因是确保他们能得到充分保护以防感染COVID-19（77%）。此外，唯一能显著预测早期疫苗接种（成为创新者或早期采用者）的接种疫苗原因是“放宽口罩强制令和社交/身体距离限制”（p = 0.0180）。在未接种COVID-19疫苗的22%的人群中，他们拒绝接种疫苗最常见的主要原因是他们认为政治在疫苗研发过程中起了很大作用（94%）。我们的研究结果表明，影响成年烟草使用者接受或拒绝接种COVID-19疫苗的主要因素包括感染控制强制令、预防COVID-19感染以及政治因素。对这些因素进行调查有助于公共卫生专业人员为高风险人群设计或制定未来的疫苗接种计划，以提高疫苗接种率。
