COVID‐19 vaccination coverage and vaccine hesitancy among people with opioid use disorder in Barcelona, Spain

Abstract

Introduction People with substance use disorders are considered a priority group for SARS‐CoV‐2 vaccination as they are at elevated risk of COVID‐19 and its severe complications. However, data are scarce about vaccination coverage in a real‐world setting. Methods A descriptive study was conducted in people with opioid use disorder (OUD) from three public centres for outpatient drug addiction treatment in Barcelona, Spain, who received brief medical advice and were referred to vaccination clinic sites. Results Three hundred and sixty‐two individuals were included: 277 (77%) were men with a mean age of 48.1 ± 8.9 years and 77% were Spanish. Most (90%) participants engaged in polysubstance use and all individuals were on opioid agonist therapy. Psychiatric comorbidity was present in 56% subjects and 32% individuals had ≥1 chronic disease, 30% had HIV and 13% hepatitis C. There were 258 fully vaccinated individuals (71%; 95% confidence interval [CI] 67, 76). Age (odds ratio [OR] 1.04; 95% CI 1.01, 1.08; P < 0.01) and Charlson Comorbidity Index (OR 1.67; 95% CI 1.11, 2.5; P < 0.01) were associated with full vaccination. The vaccination hesitancy causes cited were complacency (53, 51%), convenience (40, 39%) and confidence (11, 10%). Discussion and Conclusions More than two‐thirds of our sample of people with OUD were fully vaccinated. Complacency and convenience represented a significant barrier to complete vaccination among people with OUD on opioid agonist therapy referred to vaccination clinic sites. Additional measures are necessary to increase vaccination, especially for younger individuals and those with less medical comorbidity. Integrating vaccination services in drug outpatient centres could be a useful alternative.

Seroprevalence of SARS-CoV-2 and humoral immune responses to mRNA vaccines among people who use drugs - In the light of tailored mitigating strategies

“…However, the percentage of PWUD who received dose 2 is still on level with the total Norwegian population (19). In contrast, several studies have found a lower cumulative vaccine uptake mong PWUD compared to the general population (51)(52)(53)(54)(55)(56). Some studies suggest that this can be explained by hesitancy towards the vaccines among PWUD (52,54).…”

Risk of COVID-19 infection and the associated hospitalization, ICU admission and mortality in opioid use disorder: a systematic review and meta-analysis

“…Given the higher COVID-19 complications in OUD cases, preventive measures such as vaccination should be especially considered in them in order to reduce the COVID-19 burden in this highly susceptible population. This is of more importance as there has been a report that complacency and convenience were the main barriers to COVID-19 vaccination in people with OUD [ 60 ].…”

Perceptions of COVID-19 risk during the pandemic: perspectives from people seeking medication for opioid use disorder

“…A few participants also reported inconvenience as a reason for not getting the vaccine; among vaccine-motivated persons with OUD, low perceived risk of COVID-19 and inconvenience (e.g. geographical difficulties to access, visiting centre schedule) have been found to be the main barriers to vaccination [ 46 ]. Reducing barriers to care by providing rideshare vouchers and efforts to overcome vaccine misinformation to increase vaccination rates should be prioritized.…”