Background It is important for people with disabilities to be vaccinated against COVID-19 because, as a group, they are at increased risk of severe outcomes. While there are multiple vaccines available to prevent COVID-19, a considerable proportion of Americans report some hesitancy to becoming vaccinated, including people with disabilities. Objective We conducted a study to explore what factors may contribute to COVID-19 vaccination hesitancy among Americans with disabilities. Methods We used Amazon's Mechanical Turk to survey 439 people with disabilities (ages 18+) about their concerns of the COVID-19 disease, vaccines, and hesitancy toward vaccination to learn more about factors that influence vaccination hesitancy. Concerns about vaccines were analyzed as a composite variable representing different dimensions such as: side effects, too new, developed too quickly, influenced by politics, and effectiveness. Results Results from a logistic regression indicate that concern about vaccines was the most significant predictor of hesitancy, even after considering demographic, economic, and geographic factors. Concerns about getting COVID-19, getting tested for COVID-19, trust in experts, education, and being a Democrat were negatively associated with hesitancy. Conclusions These findings indicate that some groups of individuals may be more vaccination hesitant because they are more concerned about vaccine safety than COVID-19 infection. Public health messaging that focuses on the risks of vaccines relative to the risks of COVID-19 might be one strategy to reduce hesitancy and increase vaccination uptake. Messaging should also be tailored to specific disabilities (i.e. physical, mental, sensory), written in plain language, and disseminated in accessible formats.

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In 2016, the federal government mandated that all Medicaid-funded personal assistance services be documented through an Electronic Visit Verification (EVV) program by January 2020. Most states have asked for extensions due to difficulties in implementation and strong opposition from consumer advocacy groups. Qualitative research has documented various concerns of consumers and consumer advocates. In 2020 (prepandemic), we conducted a mail survey of consumers which included questions regarding familiarity with, and attitudes toward, EVV. Respondents could also write in qualitative comments. This paper explores consumers' perceptions of EVV using four survey items related to fraud, benefits, concerns, and protection and 25 qualitative comments related to these topics. We found that respondents agreed most with statements focused on both concerns with EVV interfering with their care and help in reducing fraud. In general, the most common quantitative response to the statements was indifference. Qualitative comments centered on concerns about EVV interfering with services in a variety of ways, although there were also comments related to EVV being protective, beneficial, or helpful in reducing fraud. We also identified a new category in the qualitative comments about consumers' beliefs that the work done by their personal assistance service workers is underrecognized. We recommend that policy makers and service organizations continue to collect information from consumers as EVV is implemented and altered to both meet the expectations of the legislation and the needs of consumers and workers.