COVID-19 Vaccine acceptability among people who inject drugs in Melbourne, Australia.

Author: Michael Curtis Ashleigh Cara Stewart Penny Hill Rebecca Thatcher Danny Jeffcote Sione Crawford Shelley Cogger Debra Alexander Sean Swift Clint Westig Ele Morrison Paul Dietze

Theme: Epidemiology and Public Health Research Year: 2021

Background: People who inject drugs (PWID) are at increased risk of experiencing adverse outcomes related to COVID-19 and, due to a range of factors, may be less likely to access vaccination services. Prior to the release of candidate vaccine efficacy data, previous work in Melbourne in November/December 2020 suggested that vaccine hesitancy may be higher among PWID than the broader population. To inform COVID-19 vaccine rollout to PWID, we surveyed Needle and Syringe Program (NSP) clients in Melbourne, Australia to determine vaccine acceptability and reasons for declining vaccination. Methods: Clients at six NSP sites participated in a brief survey between 22 February and 7 March 2021. Using a 5-item ordinal response scale, participants were asked whether they would have a free COVID-19 vaccine and, if not, why. Results: 1252 responses were collected. Most intended to have a COVID-19 vaccine, with 457 (37%) responding “definitely yes” and 247 (20%) responding “probably yes”. One-fifth (n=231, 18%) were “unsure”. Ten percent (n=127) responded they would “probably not” and 15% (n=190) would “definitely not” have a vaccine. Among those who reported they would not have a vaccine (n=317), the most common reasons were concerns around vaccine safety (n=156, 49%), believing the vaccine was unnecessary as COVID-19 is not serious for most people (n=36, 11%), and believing COVID-19 was not real (n=27, 9%). Conclusion: More than half of respondents intended to have the COVID-19 vaccine, lower than Australian population estimates but almost identical to estimates among PWID from 2020. Vaccine uptake among PWID may be improved through local health education campaigns that address populationspecific concerns, including vaccine safety, although emerging evidence may change intentions over time. Services trusted by PWID such as NSPs are well situated to deliver such campaigns. Further regular monitoring of vaccination intentions among PWID is important given their vulnerability to COVID-19. Disclosure of Interest Statement: Professor Dietze has received funding from Gilead Sciences and Indivior for work unrelated to this study. He has also served as an unpaid member of an Advisory Board for an intranasal naloxone product. The authors declare that they have no competing interests.

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