Covid-19 Vaccine Hesitancy and Under-Vaccination among Marginalized Populations in the United States and Canada: A Scoping Review

Journal of Racial and Ethnic Health Disparities, Journal Year: 2023, Volume and Issue: unknown

Published: Dec. 20, 2023

Abstract Background Amid persistent disparities in Covid-19 vaccination and burgeoning research on vaccine hesitancy (VH), we conducted a scoping review to identify multilevel determinants of VH under-vaccination among marginalized populations the U.S. Canada. Methods Using methodology developed by Joanna Briggs Institute, designed search string explored 7 databases peer-reviewed articles published from January 1, 2020–October 25, 2022. We combine frequency analysis narrative synthesis describe factors influencing populations. Results The captured 11,374 non-duplicated records, scoped 103 articles. Among 14 identified, African American/Black, Latinx, LGBTQ+, American Indian/Indigenous, people with disabilities, justice-involved were predominant focus. Thirty-two emerged as VH, structural racism/stigma institutional mistrust (structural)(n = 71) most prevalent, followed safety (vaccine-specific)(n 62), side effects 50), trust individual healthcare provider (social/community)(n 38), perceived risk infection (individual)(n 33). Structural predominated across populations, including mistrust, barriers access due limited supply/availability, distance/lack transportation, no/low paid sick days, low internet/digital technology access, lack culturally- linguistically-appropriate information. Discussion identified complex drivers Distinguishing vaccine-specific, individual, social/community that may fuel decisional ambivalence, more appropriately defined racism/structural stigma systemic/institutional better support evidence-informed interventions promote equity vaccines informed decision-making

Language: Английский

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Predictors of COVID-19 vaccine uptake among people who inject drugs

Vaccine, Journal Year: 2023, Volume and Issue: 41(12), P. 1916 - 1924

Published: Jan. 23, 2023

We studied characteristics of COVID-19 vaccination uptake among people who inject drugs (PWID). Participants aged ≥18 years injected ≤1 month ago were recruited into a community-based cohort from October 2020 to September 2021 in San Diego, California Poisson regression identified correlates having had ≥1 vaccine dose based on semi-annual follow-up interviews through March 15, 2022. Of 360 participants, 74.7% male, mean age was 42 years; 63.1% Hispanic/Mexican/Latinx. More than one-third co-morbidity. HIV and HCV seroprevalence 4.2% 50.6% respectively; 41.1% lacked health insurance. Only 37.8% reported dose. None received ≥3 doses. However, those vaccinated, 37.5% previously unwilling/unsure about vaccines. Believing vaccines include tracking devices (adjusted incidence rate ratio [aIRR]: 0.62; 95% CI: 0.42,0.92) lacking insurance (aIRR: 0.60; 0.40,0.91) associated with approximately 40% lower rates). Ever receiving influenza 2.16; 95%CI: 1.46, 3.20) testing HIV-seropositive 2.51; 1.03, 6.10) or SARS-CoV-2 RNA-positive 1.82; 1.05, 3.16) independently predicted higher rates. Older age, knowing more vaccinated people, recent incarceration also One year after became available U.S. adults, only one third PWID Multi-faceted approaches that dispel disinformation, integrate public social services increase access free, are urgently needed.

Language: Английский

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Chronic conditions, COVID-19 vaccination, and institutional trust among Hispanic/Latinx communities in San Diego, California

Preventive Medicine, Journal Year: 2025, Volume and Issue: 192, P. 108240 - 108240

Published: Feb. 3, 2025

Language: Английский

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Vaccination coverage among people who inject drugs: A systematic review

International Journal of Drug Policy, Journal Year: 2024, Volume and Issue: 127, P. 104382 - 104382

Published: March 19, 2024

People who inject drugs may be at excess risk of acquiring vaccine-preventable diseases and negative associated health outcomes, but experience barriers to vaccination. We aimed determine vaccination coverage among people globally. conducted systematic searches the peer-reviewed grey literature, date limited from January 2008 August 2023, focusing on for which are elevated an adult dose is recommended (COVID-19, hepatitis A, B, human papillomavirus, influenza, pneumococcal disease, tetanus). To summarise available data, we a narrative synthesis. included 78 studies/reports comprising 117 estimates across 36 countries. Most were obtained high income countries (80%, n=94). located B in 33 countries, 18 with data serological evidence vaccine-derived immunity (range: 6-53%) 22 self-report vaccine uptake (<1-96%). Data other vaccines scarcer: reported A ranged 3-89% (five countries), COVID-19 4-84% while fewer than five tetanus, papillomavirus. Estimates sparse where indicative suboptimal drugs. Improving consistency, timeliness, geographic this population essential inform efforts increase uptake.

Language: Английский

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Vaccine decision making among people who inject drugs: Improving on the WHO's 3C model of vaccine hesitancy

Preventive Medicine Reports, Journal Year: 2023, Volume and Issue: 35, P. 102341 - 102341

Published: July 22, 2023

The objectives of this study were to 1) identify vaccination rates among PWID in Oregon at a time when vaccines easily accessible, 2) quantitatively convergence with demographic correlates willingness and uptake promote generalizability, 3) explore the factors considering deciding whether or not receive COVID-19 vaccine. We conducted mixed-methods design including 260 quantitative surveys 41 in-depth qualitative interviews PWID, July - September 2021 syringe services programs Lane County, Oregon. Among survey respondents, 37.3% indicated that they had received vaccine by October 1, 2021. In same period, an estimated 70.1% total County population completed their vaccinations (not booster rounds). explored alignment WHO's 3 C model hesitancy identified, instead, five common as key motivators for decisions: confidence, convenience, concern, communication, community implications PWID. Interviews describe systemic barriers which prevented from accessing healthcare resources. highlight our proposed 5C identified may more accurately depict how navigate decisions incorporating ways social inequities, infrastructural barriers, values influence individual's deliberation.

Language: Английский

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Study protocol for a pilot randomized controlled trial to increase COVID-19 testing and vaccination among people who inject drugs in San Diego County

Addiction Science & Clinical Practice, Journal Year: 2022, Volume and Issue: 17(1)

Published: Sept. 5, 2022

People who inject drugs (PWID) have low rates of COVID-19 testing and vaccination are vulnerable to severe disease. We partnered with a local, community-based syringe service program (SSP) in San Diego County, CA, develop the single-session theory- evidence-informed "LinkUP" intervention increase vaccination. This paper details protocol for pilot randomized controlled trial (RCT) LinkUP intervention.

Language: Английский

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Controlled Human Infection Model for Hepatitis C Virus Vaccine Development: Trial Design Considerations

Clinical Infectious Diseases, Journal Year: 2023, Volume and Issue: 77(Supplement_3), P. S262 - S269

Published: Aug. 14, 2023

The design of a clinical trial for controlled human infection model (CHIM) to accelerate hepatitis C virus (HCV) vaccine development requires careful consideration. potential approach HCV CHIM is outlined, involving initial sentinel cohorts establish the safety and curability viral inoculum followed by larger spontaneous clearance rate each inoculum. primary endpoint would be 24 weeks post-inoculation, recognizing that prevention chronic goal candidates. Additional considerations are discussed, including populations enrolled, required monitoring approach, indications antiviral therapy, sample size different approaches. Finally, participants discussed.

Language: Английский

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Time-to-completion of COVID-19 vaccination primary series varies by HIV viral load status among people who inject drugs in Baltimore, Maryland

Preventive Medicine Reports, Journal Year: 2023, Volume and Issue: 36, P. 102448 - 102448

Published: Sept. 28, 2023

People who inject drugs (PWID) may have diminished access to essential preventive services like COVID-19 vaccination given structural and substance use barriers. We aimed assess the role of HIV on uptake among adult PWID participating in ALIVE cohort study Baltimore, Maryland were alive as April 2021. abstracted data from electronic medical records via regional health information exchange. used Kaplan-Meier method estimate time universal vaccine eligibility (April 6, 2021) completion primary series (1 dose J&J or 2 doses mRNA) by viral load status (uninfected, PWH [HIV-RNA<400 copies/mL], [HIV-RNA≥400 copies/mL]) Cox Proportional Hazards regression adjust for potential confounders. Our sample (N=960) was primarily black (77%) male (65%) with 31% reporting recent injection drug use. Among 265 (27%) people living (PWH) our sample, 84% virally suppressed. As February 22, 2022, 539 (56%) completed series, 131 (14%) received a single mRNA 290 (30%) remained unvaccinated. Compared without HIV, suppressed more likely complete (Adjusted Hazard Ratio [aHR]:1.23,95% Confidence Interval [95%CI]:1.07,1.50), while not less (aHR:0.72,95%CI:0.45,1.16), although this statistically significant. conclude that PWID, infection suppression is associated quicker uptake, due care engagement. Targeted improvements along continuum bolster uptake.

Language: Английский

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A Brief Peer-Led Intervention to Increase COVID-19 Vaccine Uptake Among People Who Inject Drugs in San Diego County: Results From a Pilot Randomized Controlled Trial

Open Forum Infectious Diseases, Journal Year: 2023, Volume and Issue: 10(8)

Published: July 21, 2023

We evaluated the impact of a brief peer-led intervention on COVID-19 vaccination among people who inject drugs (PWID) presenting at syringe services program (SSP) locations in San Diego County, California. Between March and July 2022, PWID aged ≥18 years without recent voluntary testing were not up to date vaccinations received single-session motivational interviewing (LinkUP) or an attention-matched didactic control condition from trained peer counselors SSP sites randomized by week. Following either 30-minute session, offered referrals local services. Multivariable log binomial regression via generalized estimating equations assessed LinkUP effects (1) acceptance immediately postintervention (2) vaccine uptake 6-month follow-up. outcomes obtained 135 (90.6%) 149 participants. In multivariable analysis, participants receiving had greater than controls (adjusted relative risk, 3.50; 95% CI, 1.01-12.2) marginally more likely report new dose 1.57; .99-2.48). After 6 months, 20% reported dose; however, if been available SSPs, this proportion could have as high 34.3% (45.3% vs 24.3% control; P = .01). A SSP-based significantly improved PWID. Further improvements be supporting SSPs offer on-site instead relying referrals. ClinicalTrials.gov NCT05181657.

Language: Английский

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Protective or potentially harmful? Altering drug consumption behaviors in response to xylazine adulteration

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 7, 2024

Background Xylazine is an increasingly common adulterant in the North American unregulated drug supply that associated with adverse health outcomes (e.g., skin infections, overdose). However, there are significant knowledge gaps regarding how xylazine was initially identified and syringe services program (SSP) staff clients (people who use drugs) responded to its emergence. Methods From June–July 2023, we conducted qualitative interviews medical clinicians) frontline SSP outreach workers) adult a history of injection at Miami-based SSP. Inductive memos emergent codes; thematic analysis involving team consensus established final themes. Results (n = 8) 17), emergence different times, various ways. Initially, during summer 2022, “tranquilizer-like substance” worsened sedation withdrawal caused wounds. later this as by treating new cases through diverse information-sharing networks included professional societies news sources; however, needed additional educational resources about side effects. With limited guidance on reduce harm from xylazine, altered their consumption routes, reduced use, relied peers’ experiences protect themselves. Some individuals also reported preferring xylazine-adulterated opioids increasing including stimulants avoid over sedation. Conclusions Xylazine’s characterizes current era unprecedented shifts supply. We found spurred important behavioral changes among people drugs transitioning injecting smoking). Incorporating these into early warning surveillance systems scaling up drug-checking safer smoking distribution could help mitigate harms other adulterants.

Language: Английский

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