COVID-19 Vaccination Attitudes Among People in Australia Who Inject Drugs

Author: Olivia Price Paul Dietze Lisa Maher Sione Crawford Mallory Trent Gregory Dore Rachel Sutherland Raimondo Bruno Caroline Salom Simon Lenton Louisa Degenhardt Amy Peacock Caroline

Theme: Epidemiology & Public Health Research Year: 2022

People who inject drugs may be at greater risk of adverse outcomes from SARS-CoV-2 infection but
are less likely to be vaccinated. The aim of this study was to explore patterns of COVID-19
vaccination attitudes among this demographic in Australia.
A sentinel sample of 888 people who regularly inject drugs were recruited from Australian capital
cities in June-July 2021, when COVID-19 vaccines were available only to priority groups. Latent
classes based on attitudes towards vaccination were identified. Multinomial logistic regression
models were used to examine factors associated with class membership, and conditional
probabilities of endorsing factors that would increase likelihood for vaccine uptake given class
membership calculated.
We identified three classes of participants: vaccine acceptant (33%), hesitant (36%), and rejecting
(31%). Relative to the acceptant class, hesitant participants were more likely to reside in unstable
housing, and relative to acceptant and rejecting classes, more likely to report past six-month general
practitioner attendance. The rejecting group were more likely than acceptant and hesitant groups to
report injecting drugs ≥daily in the past month (versus <daily) and injecting methamphetamine most
frequently (versus heroin). Participants in hesitant and rejecting groups were less likely to report
current season influenza vaccination than acceptant participants. Vaccine hesitant participants were
consistently more likely to endorse facilitators of vaccine uptake than rejecting participants,
including vaccine delivery at needle-syringe programs and peer worker recommendation for
vaccination. Financial incentives were the most highly endorsed facilitator across all three groups.
Vaccine hesitant participants in our study were engaged with the healthcare system; this touchpoint
could be utilised to encourage vaccine uptake. More concentrated efforts are required to vaccinate
those who may be less service engaged, including people who predominantly inject
methamphetamine and those who are unstably housed. Financial incentives may improve uptake
among people who inject drugs.
Disclosure of Interest Statement:
AP has received untied educational grant from Seqirus and Mundipharma for study of opioid
medications. PD has received untied educational grant from Gilead sciences for work related to
hepatitis C and an untied educational grant from Indivior. PD and SL have served as an unpaid
member of an Advisory Board for Mundipharma. RB has received untied educational grant from
Mundipharma and Indivior for study of opioid medications. LD has received untied educational
grants from Seqirus, Indivior and Mundipharma for study of opioid medications. All other authors
have no conflicts of interest to declare.

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