Acceptance of COVID-19 Vaccine Among Refugees in the United States

Abstract

Objective Little is known about COVID-19 vaccination intentions among refugee communities in the United States. The objective of this study was to measure COVID-19 vaccination intentions among a sample of refugees in the United States and the reasons for their vaccine acceptance or hesitancy. Methods From December 2020 through January 2021, we emailed or text messaged anonymous online surveys to 12 bilingual leaders in the Afghan, Bhutanese, Somali, South Sudanese, and Burmese refugee communities in the United States. We asked community leaders to complete the survey and share the link with community members who met the inclusion criteria (arrived in the United States as refugees, were aged ≥18, and currently lived in the United States). We compared the characteristics of respondents who intended to receive the COVID-19 vaccine with those of respondents who did not intend to receive the vaccine or were unsure. We then conducted crude and adjusted logistic regression analysis to measure the association between employment as an essential worker and COVID-19 vaccine acceptance. Results Of 435 respondents, 306 (70.3%) indicated that they planned to receive a COVID-19 vaccine. Being an essential worker (adjusted odds ratio [aOR] = 2.37; 95% CI, 1.44-3.90) and male sex (aOR = 1.87; 95% CI, 1.12-3.12) were significantly associated with higher odds of intending to receive a COVID-19 vaccine. Among respondents who intended to receive a COVID-19 vaccine, wanting to protect themselves (68.6%), family members (65.0%), and other people (54.3%) were the main reasons. Conclusion Many refugees who responded to the survey, especially those who worked in essential industries, intended to receive a COVID-19 vaccine. Community organizations, health care providers, and public health agencies should work together to ensure that vaccine registration and vaccination sites are accessible to refugees.

Vaccine hesitancy in the refugee, immigrant, and migrant population in the United States: A systematic review and meta-analysis

“…The included studies addressed human papillomavirus (HPV) (n = 25), 21 , 29–31 , 35 , 37 , 40 , 42 , 44 , 46–48 , 50 , 53 , 55 , 57 , 60 , 61 , 65–68 , 71 , 72 , 74 influenza (n = 14), 20 , 24–26 , 28 , 36 , 41 , 46 , 47 , 52 , 58 , 59 , 63 , 64 hepatitis B (n = 11), 22 , 27 , 34 , 39 , 42 , 43 , 46 , 49 , 51 , 56 , 75 COVID-19 (n = 9), 18 , 19 , 23 , 32 , 38 , 45 , 54 , 69 , 73 pneumococcal (n = 6), 26 , 41 , 46 , 47 , 58 , 59 tetanus, diphtheria, pertussis/tetanus diphtheria (Tdap/Td) (n = 6), 33 , 41 , 42 , 46 , 47 , 62 hepatitis A (n = 2), 42 ...…”

Increasing COVID-19 Vaccine Uptake in the United States: Addressing Reasons for Vaccine Hesitancy through Effective Communications & Reform

“…Of these 16 articles stating side effects as the main reason for hesitancy, twelve included general side effects, two included adverse/unknown effects, and two included general safety and effectiveness (see Table 4). Only five articles analyzed side effect concerns, which include well-documented flu-like symptoms after receiving the COVID-19 vaccine, 17,18,30 rare severe adverse reactions such as allergic reactions and thrombosis, 22,18 and unknown and/or long-term effects. 30,36,17 21.42% of the articles found additional information needed as the top reason for hesitancy among their population.…”

“…Only five articles analyzed side effect concerns, which include well-documented flu-like symptoms after receiving the COVID-19 vaccine, 17,18,30 rare severe adverse reactions such as allergic reactions and thrombosis, 22,18 and unknown and/or long-term effects. 30,36,17 21.42% of the articles found additional information needed as the top reason for hesitancy among their population. This percentage includes those who "plan to wait and see if it is safe to get later" and those who cited lack of evidence.…”

“…The American population expressed concern about short-term side effects, including flu-like symptoms such as headache and fatigue, as a reason for vaccine hesitancy. 17,18,30 Those who are hesitant because of side effects also expressed concern about long-term impacts, which include side effects that are "unknown" and could be detrimental to personal health, 36,30,17 severe and adverse allergic reactions. 22,18 Fear of these side effects stem from transparent data on flu-like symptoms, rare allergic reactions, and rare thrombosis cases.…”

The COVID-19 vaccination experience of non-English speaking immigrant and refugee communities of color: A community co-created study

“… 10 - 12 Studies at the beginning of the COVID-19 vaccine rollout examining perspectives of COVID-19 vaccines among non-English speaking IRC communities showed relatively high interest in getting vaccinated. 13 , 14 However, IRC communities described several concerns about getting vaccinated, including being questioned for identification, the perception that getting vaccinated would fall under the definition of “public charge” (which certified that use of public services may be sufficient foundation for denying visa or green card applications), lack of linguistically affirming services (i.e. services in the language they prefer for medical care), and concern that getting vaccinated would lead to decreased wages or punitive measures from employers.…”