COVID-19 vaccine hesitancy in adults with multiple sclerosis in the United States: A follow up survey during the initial vaccine rollout in 2021

Abstract

Background: Multiple sclerosis (MS) organizations have recommended that adults with MS obtain the COVID-19 vaccination. Vaccine hesitancy is a barrier to full COVID-19 inoculation in the general population. Whether vaccine hesitancy is also a barrier towards optimizing vaccination rates in the MS community is unknown. To investigate vaccine hesitancy and inform efforts to increase vaccine uptake in the MS population, we conducted a follow up survey of a national sample of adults with MS living in the United States who completed an initial survey early in the COVID-19 pandemic. The current study aimed to answer questions vital to understanding vaccine hesitancy, specifically: (1) What is the prevalence of COVID-19 vaccine hesitancy in early 2021? (2) What are the reasons for and factors associated with current hesitancy? (3) How has vaccine willingness and hesitancy changed from April/May 2020 to January/February 2021? and (4) Who has changed in their vaccine willingness? Methods: Adults with MS living in the United States (N = 359) completed two online surveys (the first between 10 April 2020 and 06 May 2020; the second between 11 January 2021 and 08 February 2021) about their willingness and intent to obtain a COVID-19 vaccine. Participants also completed measures to assess factors potentially related to vaccine hesitancy, including demographics, MS variables, influenza vaccine history, vaccine concerns, and contextual factors, including perceived risk for SARS-CoV-2 infection, trust in COVID-19 information source, anxiety, and loneliness. Results: Of the participants who completed the second survey in early 2021, 20.3% were vaccine hesitant, that is, either reporting that they were undecided (13.9%) or not intending to get vaccinated (6.4%). Vaccine hesitancy decreased between the two surveys, with nearly three-fourths (73.8%) of the second sample reporting that they planned to obtain the COVID-19 vaccine. Vaccine hesitancy was associated with having a lower level of education, being non-White, not having a recent flu vaccination, holding a lower perception of one's risk of getting COVID-19, and having lower trust in the Centers for Disease Control and Prevention. Participants who were vaccine hesitant reported concerns about the long-term effects of the vaccine, the vaccine approval process, and the potential impact of the vaccine given their own health conditions/history. Notably, 90% of the undecided group wanted additional information about the vaccine before deciding. Vaccine willingness changed over time, with many of those who were somewhat willing more willing to get the COVID-19 vaccine at survey 2. Individuals who were unwilling at survey 1 were highly likely to remain unwilling at survey 2. Conclusion: Overall, COVID-19 vaccine hesitancy decreased during the pandemic, although one in five adults with MS were hesitant in early 2021. Of those who were undecided, most indicated that they wanted additional information about the vaccine before deciding whether to be vaccinated, suggesting additional educa...

Multilevel determinants of COVID-19 vaccination hesitancy in the United States: A rapid systematic review

“…Race/ethnicity . Whites ( Malik et al, 2020 , Dalal et al, 2021 , Thompson et al, 2021 , Ehde et al, 2021 ), Asians ( Szilagyi et al, 2021 , Malik et al, 2020 , Shaw et al, 2021 , Shekhar et al, 2021 , Thompson et al, 2021 , Townsel et al, 2021 ) and American Indians/Alaska Natives ( Malik et al, 2020 , Stern et al, 2021 ) were found to be more likely to vaccinate against COVID-19. However, compared to White race, Black race and Hispanic/Latinx origin were associated with 2 to 6-fold ( Daly and Robinson, 2021 , Fisher et al, 2020 , Latkin et al, 2021 , Salmon et al, 2021 , Nikolovski et al, 2021 , Halbrook et al, 2021 , Saluja et al, 2021 , Caban-Martinez et al, 2021 , Townsel et al, 2021 , Bass et al, 2021 , Jacobi and Vaidyanathan, 2021 , Yang et al, 2021 , Nguyen et al, 2021 ) and 2 to 3-fold ( Fisher et al, 2020 , Latkin et al, 2021 , Saluja et al, 2021 , Caban-Martinez et al, 2021 ) higher chance of being COVID-19 vaccine hesitant, respectively.…”

COVID-19 Vaccination Reactogenicity in Persons With Multiple Sclerosis

“… 6 , 7 Frequent concerns for vaccine hesitant PwMS were vaccine safety and efficacy and potential short- and long-term side effects. 6 , 8 In addition, most vaccine hesitant PwMS expressed the desire for additional information. 8 Unfortunately, no safety data pertaining specifically to PwMS have been reported from the various SARS-CoV-2 vaccine trials, and extrapolation of the safety data from the general population to PwMS is unclear, largely due to the uncertain impact of DMTs.…”

“… 6 , 8 In addition, most vaccine hesitant PwMS expressed the desire for additional information. 8 Unfortunately, no safety data pertaining specifically to PwMS have been reported from the various SARS-CoV-2 vaccine trials, and extrapolation of the safety data from the general population to PwMS is unclear, largely due to the uncertain impact of DMTs. We investigated the relationships between sociodemographic/clinical attributes and DMT status on short-term (24 hours) SARS-CoV-2 vaccine reactogenicity in PwMS participating in an online research network.…”

“…This is especially important because >20% of PwMS may be vaccine hesitant, 6 , 7 with specific concerns related to vaccine safety, vaccine efficacy, and potential side effects. 6 , 8 Among vaccine-hesitant PwMS, short-term side effects were a major concern for 26% and a minor concern for 49% of individuals. 8 …”

“… 6 , 8 Among vaccine-hesitant PwMS, short-term side effects were a major concern for 26% and a minor concern for 49% of individuals. 8 …”