COVID-19 Vaccine Hesitancy and Its Determinants Among Adults with a History of Tobacco or Marijuana Use

Abstract

Decreasing COVID-19 vaccine hesitancy is an urgent challenge in the US. This study aimed to examine COVID-19 vaccine hesitancy among U.S. adults with a history of using tobacco products or marijuana. Data were collected online in 2020-2021 including respondents' willingness to accept a COVID-19 vaccine, factors that may promote vaccine acceptance, and prior history of influenza vaccination. Logistic regression models were conducted to estimate the associations between vaccine hesitancy and demographic characteristics, substance use, the impact of the COVID-19 pandemic, and prior influenza vaccination. Among 387 respondents, 49.1% were willing to receive a COVID-19 vaccine, 26.0% were unwilling, and 24.9% were "not sure." Blacks, suburban or rural residents, those who lived by themselves or with a family with five members or above, those who were not stressed because of the COVID-19 pandemic were more likely to say "no" to a COVID-19 vaccine. Respondents who never, only once, or during some years received an influenza vaccine were 7.0, 6.2, and 5.2 times more likely to say "no" to a COVID-19 vaccine than respondents who received an influenza vaccination every year or almost every year. The use of cigarettes, e-cigarettes, and marijuana, as well as heavy drinking of alcohol, were not associated with COVID-19 hesitancy. The associations between demographic factors and vaccine hesitancy were roughly similar for COVID-19 and influenza vaccines. Although various demographic groups have different levels of vaccine hesitancy and also have different factors to increase their acceptance, addressing misinformation related to COVID-19 vaccines, particularly concern about the safety of the vaccines is crucial in general.

Young Adults’ Intentions and Rationales for COVID-19 Vaccination Participation: Evidence from a Student Survey in Ho Chi Minh City, Vietnam

“…The previous study revealed that knowledge about the COVID-19 pandemic and its impacts have a moderate, positive relationship with vaccination. In terms of the severity of the COVID-19 pandemic, the studies [23,[31][32][33][34][35] found that individuals who were fearful of getting infected with COVID-19 viruses were more inclined to receive COVID-19 vaccines than those who were not. Consistently, Md Abul Kalam and his contemporaries (2021) also concluded that the severity of a COVID-19 infection was significantly correlated with vaccination uptake [36].…”

“…Some research found out that people who were concerned about the efficacy of vaccines likely have higher odds of refusal or hesitation about taking them [37,39], while others who believed vaccines were safe were more likely to get vaccinated [36]. Besides, in terms of side effects, subjects who were willing to accept the COVID-19 vaccine expressed less concern about the side effects in comparison to those who opted out of vaccination against COVID-19 [35,36,40]. Using Chile as a case study, García and Cerda (2020) [40] find that public acceptance toward the COVID-19 vaccine depends on the efficiency of the government at handling the pandemic.…”

Motivations to Vaccinate Among Hesitant Adopters of the COVID-19 Vaccine

“…More than 37 million cases of COVID-19 have been documented in the United States (US) since the beginning of the pandemic [ 1 ]. Vaccination remains a critical means for mitigating the worst effects of the pandemic in the US [ 2 , 3 ]. COVID-19 vaccines became available in December 2020 [ 4 ] and initially had high demand; however, the rate of vaccination slowed during the summer of 2021 [ 5 ].…”

“…Recent studies have focused on quantitative analysis of sociodemographic and other predictive factors of vaccine hesitancy [ 7 , 8 ]. These studies have documented that vaccine hesitancy is higher among Black Americans, residents in rural areas, women, younger individuals, and those with lower educational attainment and lower income [ 3 , 7 , 8 ]. Qualitative work on vaccine hesitancy has likewise focused primarily on reasons for vaccine refusal [ 9 , 10 ], documenting concerns with the speed of vaccine development [ 11 ], lower trust in medical professionals, researchers, and government [ 12 ], and fears related to the safety and efficacy of COVID-19 vaccines [ 13 ].…”

Increased COVID-19 infection risk, COVID-19 vaccine inaccessibility, and unacceptability: Worrisome trio for patients with substance abuse disorders

“…A cross-sectional study in the U.S has shown decreased willingness to be vaccinated against COVID-19 in the vulnerable population that overdoses on cannabis [ 12 ]. Another study in the U.S showed that 52.3% of adults who used marijuana, and 55.6% of adults who heavily drank at least once in the past 30 days were indecisive or unwilling to receive the COVID-19 vaccine [ 13 ]. Low rates of literacy and awareness can lead to misinterpretation of COVID-19 symptoms in opiate users as signs of withdrawal, which leads to further dosing of opioids [ 10 ].…”