Karimi Salah Eddin, Ahmadi Sina, SoleimanvandiAzar Neda, Rampisheh Zahra, Nojomi Marzieh, Sepahvand Elham, Tavangar Fateh, Tehrani-Banihashemi Seyed Arash, Tayefi Batool, Higgs Peter
Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Health Policy and Management, Tabriz Health Services Management Research Center, School of Management & Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Infect Dis. 2025 Jul 11;25(1):909. doi: 10.1186/s12879-025-11248-z.
People Who Use Drugs (PWUD), are a population at the high risk of exposure to infectious disease and should be considered as a priority for vaccination against communicable diseases. However, during the COVID-19 pandemic this population showed resistance to vaccination. The aim of this study was to better understand the barriers and facilitators of COVID-19 vaccination in PWUD in Tehran, Iran.
In this qualitative study data were collected through semi-structured interviews with participants through purposeful sampling with maximum variation. The collected data were analyzed using content analysis informed by Graneheim and Lundman using MAXQDA-10 Software. Lincoln and Guba's criteria were used to ensure the accuracy and validity of the data.
Our study results were presented under two main themes: barriers and facilitators to COVID-19 vaccination acceptance among PWUD. Based on the results of this study, the most important barriers to COVID-19 vaccine acceptance were; Stereotyped beliefs (The belief that drug users will not get infected with COVID-19, Ineffectiveness of COVID-19 vaccine, The negative effect of vaccine on underlying disease, Lack of trust in healthcare system and the type of vaccine), Low health literacy and knowledge (Neglecting health and underestimating the disease, Not prioritizing the health, Low health literacy, Believing in self-treatment and traditional medicine, Available rumors), low social capital(including having limited social networks, believing misinformation and perceived powerlessness), Structural and Experiential Barriers (Lack of access to vaccine, Unpleasant past experiences in related with the vaccination), and fear and worry caused by previous experiences(Death or illness of friends/people around who had been vaccinated, Fear of the vaccine). In addition, the most important facilitators of COVID-19 vaccine acceptance can also be classified into 2 categories of The role of incentives and social responsibility(Incentive payments, Social responsibility, Immune system strengthening as a motivation for vaccination) and Rebuilding Trust and Improving Public Perceptions (Compensating for past mistakes, The effect of advertisement by physicians and officials).
Given the possibility of future pandemics the role of vaccination in the prevention and control of communicable diseases, it is imperative to reduce the most negative consequences of pandemics for the general public and high-risk groups. Barriers to vaccination can be minimized through effective engagement with different social groups the goal of which is to effectively explain the benefits of vaccination. When planned and implemented well this will maintain health and prevent deaths in future pandemics. Health care policymakers can use the results of this study to reduce the barriers to vaccination and encourage high risk social groups to receive vaccination in future pandemics.
吸毒者是感染传染病风险较高的人群，应被视为传染病疫苗接种的优先对象。然而，在新冠疫情期间，这一人群对疫苗接种表现出抵触情绪。本研究的目的是更好地了解伊朗德黑兰吸毒者接种新冠疫苗的障碍和促进因素。
在这项定性研究中，通过目的抽样和最大变异法，对参与者进行半结构化访谈来收集数据。使用MAXQDA - 10软件，采用由格兰内海姆和伦德曼提出的内容分析法对收集到的数据进行分析。运用林肯和古巴的标准来确保数据的准确性和有效性。
我们的研究结果主要分为两个主题呈现：吸毒者接受新冠疫苗接种的障碍和促进因素。基于本研究结果，新冠疫苗接种接受度的最重要障碍包括：刻板观念（认为吸毒者不会感染新冠病毒、新冠疫苗无效、疫苗对基础疾病有负面影响、对医疗系统和疫苗类型缺乏信任）、健康素养和知识水平低（忽视健康并低估疾病、不将健康列为优先事项、健康素养低、相信自我治疗和传统医学、存在流传的谣言）、社会资本低（包括社交网络有限、相信错误信息和感到无力）、结构和经验障碍（无法获取疫苗、过去接种疫苗的不愉快经历）以及既往经历导致的恐惧和担忧（接种疫苗的朋友/周围的人死亡或患病、对疫苗的恐惧）。此外，新冠疫苗接种接受度的最重要促进因素也可分为两类：激励措施和社会责任的作用（激励性支付、社会责任、增强免疫系统作为接种疫苗的动机）以及重建信任和改善公众认知（弥补过去的错误、医生和官员的宣传效果）。
鉴于未来可能发生大流行，以及疫苗接种在预防和控制传染病中的作用，必须尽量减少大流行对公众和高危群体造成的最负面后果。通过与不同社会群体进行有效互动，以有效解释疫苗接种的益处，可以将疫苗接种的障碍降至最低。如果规划和实施得当，这将在未来大流行中维护健康并预防死亡。医疗保健政策制定者可以利用本研究结果减少疫苗接种障碍，并鼓励高危社会群体在未来大流行中接种疫苗。
