COVID-19 vaccine hesitancy in adults with multiple sclerosis in the United States: A follow up survey during the initial vaccine rollout in 2021.
COVID-19 vaccine hesitancy in adults with multiple sclerosis in the United States: A follow up survey during the initial vaccine rollout in 2021.
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DOI：
10.1016/j.msard.2021.103163
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发表时间：
2021-09
影响因子：
4
通讯作者：
Alschuler KN
中科院分区：
文献类型：
--
作者：
Ehde DM;Roberts MK;Humbert AT;Herring TE;Alschuler KN
多发性硬化症（MS）组织建议患有MS的成年人接种COVID-19疫苗。疫苗犹豫是普通人群全面接种COVID-19的障碍。疫苗犹豫是否也是MS社区优化疫苗接种率的障碍尚不清楚。为了调查疫苗犹豫并为增加MS人群的疫苗接种提供信息，我们对在COVID-19大流行早期完成初步调查的居住在美国的MS成人全国样本进行了随访调查。目前的研究旨在回答对理解疫苗犹豫至关重要的问题，具体而言：（1）2021年初COVID-19疫苗犹豫的患病率是多少？(2)目前犹豫不决的原因和相关因素是什么？(3)从2020年4月/5月到2021年1月/2月，疫苗接种意愿和犹豫有何变化？（4）哪些人的疫苗接种意愿发生了变化？居住在美国的MS成年患者（N = 359）完成了两项关于他们获得COVID-19疫苗的意愿和意图的在线调查（第一项在2020年4月10日至2020年5月6日之间;第二项在2021年1月11日至2021年2月8日之间）。参与者还完成了评估可能与疫苗犹豫有关的因素的措施，包括人口统计学，MS变量，流感疫苗接种史，疫苗问题和背景因素，包括SARS-CoV-2感染的感知风险，对COVID-19信息来源的信任，焦虑和孤独。在2021年初完成第二次调查的参与者中，20.3%的人对疫苗犹豫不决，即报告他们尚未决定（13.9%）或不打算接种疫苗（6.4%）。两次调查之间的疫苗犹豫减少，第二次调查中近四分之三（73.8%）的人报告说他们计划获得COVID-19疫苗。疫苗犹豫与受教育程度较低、非白人、最近没有接种流感疫苗、对感染COVID-19的风险认识较低以及对疾病控制和预防中心的信任度较低有关。对疫苗犹豫不决的参与者报告了对疫苗的长期影响、疫苗批准过程以及疫苗对自身健康状况/病史的潜在影响的担忧。值得注意的是，90%的未决定组希望在决定之前获得有关疫苗的更多信息。疫苗接种意愿随着时间的推移而变化，在调查2中，许多有一定意愿的人更愿意接种COVID-19疫苗。在调查1中不愿意的人很可能在调查2中仍然不愿意。整体而言，尽管2021年初五分之一患有多发性硬化症的成年人犹豫不决，但COVID-19疫苗犹豫在大流行期间有所减少。在那些尚未决定的人中，大多数人表示，他们希望在决定是否接种疫苗之前获得有关疫苗的更多信息，这表明仍然需要对疫苗的安全性，长期影响和潜在的健康影响进行更多的教育工作。研究结果表明，公共卫生工作可能最好集中在那些尚未决定的人身上，他们的疫苗犹豫可能会随着时间的推移而改变，并且可能会有适当的信息或干预。
Multiple sclerosis (MS) organizations have recommended that adults with MS obtain the COVID-19 vaccination. Vaccine hesitancy is a barrier to full COVID-19 inoculation in the general population. Whether vaccine hesitancy is also a barrier towards optimizing vaccination rates in the MS community is unknown. To investigate vaccine hesitancy and inform efforts to increase vaccine uptake in the MS population, we conducted a follow up survey of a national sample of adults with MS living in the United States who completed an initial survey early in the COVID-19 pandemic. The current study aimed to answer questions vital to understanding vaccine hesitancy, specifically: (1) What is the prevalence of COVID-19 vaccine hesitancy in early 2021? (2) What are the reasons for and factors associated with current hesitancy? (3) How has vaccine willingness and hesitancy changed from April/May 2020 to January/February 2021? and (4) Who has changed in their vaccine willingness? Adults with MS living in the United States (N = 359) completed two online surveys (the first between 10 April 2020 and 06 May 2020; the second between 11 January 2021 and 08 February 2021) about their willingness and intent to obtain a COVID-19 vaccine. Participants also completed measures to assess factors potentially related to vaccine hesitancy, including demographics, MS variables, influenza vaccine history, vaccine concerns, and contextual factors, including perceived risk for SARS-CoV-2 infection, trust in COVID-19 information source, anxiety, and loneliness. Of the participants who completed the second survey in early 2021, 20.3% were vaccine hesitant, that is, either reporting that they were undecided (13.9%) or not intending to get vaccinated (6.4%). Vaccine hesitancy decreased between the two surveys, with nearly three-fourths (73.8%) of the second sample reporting that they planned to obtain the COVID-19 vaccine. Vaccine hesitancy was associated with having a lower level of education, being non-White, not having a recent flu vaccination, holding a lower perception of one's risk of getting COVID-19, and having lower trust in the Centers for Disease Control and Prevention. Participants who were vaccine hesitant reported concerns about the long-term effects of the vaccine, the vaccine approval process, and the potential impact of the vaccine given their own health conditions/history. Notably, 90% of the undecided group wanted additional information about the vaccine before deciding. Vaccine willingness changed over time, with many of those who were somewhat willing more willing to get the COVID-19 vaccine at survey 2. Individuals who were unwilling at survey 1 were highly likely to remain unwilling at survey 2. Overall, COVID-19 vaccine hesitancy decreased during the pandemic, although one in five adults with MS were hesitant in early 2021. Of those who were undecided, most indicated that they wanted additional information about the vaccine before deciding whether to be vaccinated, suggesting additional educational efforts on the vaccine's safety, long-term effects, and potential health implications are still needed. Findings indicate that public health efforts may be best focused on those who are undecided, whose vaccine hesitancy may change over time and, possibly, with appropriate information or intervention.
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