Perceptions of and Willingness to Receive COVID-19 Vaccination Among Unvaccinated People Who Use Drugs: New York City, Spring 2021

Author: Ashly Jordan Rwaida Izar Renée Nicolas Nisha Beharie Alexandra Harocopos

Theme: Epidemiology & Public Health Research Year: 2022

People who use drugs (PWUD) have higher rates of COVID-19 infection, illness, and death. COVID-19
vaccination reduces COVID-19-related morbidity and mortality. However, stigmatization and
structural factors may be barriers for PWUD in receiving COVID-19 information and vaccination.
A rapid survey-based assessment of 100 PWUD in NYC (Spring 2021) who reported past 30-day illicit
drug use and were unvaccinated was conducted to explore willingness to receive a COVID-19
Majorities of participants simultaneously held beliefs that appeared contradictory, suggesting
COVID-19 vaccine-related ambivalence. For example, 83% agreed that vaccines were important for
the health of their communities, yet 76% felt that they were deceived about general vaccine
efficacy; 60% held both views. 80% agreed that COVID-19 vaccines were safe for people of their race
and ethnicity, yet 83% expressed concerns about potential adverse effects; 65% held both views.
82% agreed that being COVID-19 vaccinated oneself was important for the health of their
community; agreement with this statement was significantly associated with COVID-19 vaccine
willingness. 62% reported being unwilling to receive COVID-19 vaccination, yet 40% were ambivalent
about that decision. 56% reported harm reduction programs as trust COVID-19 vaccine sources.
However, most common sources and most trusted sources of COVID-19 information were not
overlapping except for healthcare providers; those reporting confidence in healthcare providers
were significantly more likely to be willing to receive COVID-19 vaccination.
Findings suggest a complex relationship regarding COVID-19-related information. Nearly half
reporting COVID-19 vaccination unwillingness, may not have firmly fixed vaccination opposition,
indicating potential opportunities to address questions and build confidence. Majorities expressed
altruistic beliefs in the importance of vaccination for community health; this altruism was associated
with willingness to be vaccinated. Recognizing and resolving vaccine ambivalence, leveraging
altruism, and messaging from trusted sources emphasizing collective and individual benefits of
vaccination may be promising approaches.
Disclosure of Interest Statement
No conflicts of interest and therefore, none to disclose.

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