Trends in COVID-19 vaccination intent and factors associated with deliberation and reluctance among adult homeless shelter residents and staff, 1 November 2020 to 28 February 2021 – King County, Washington

Vaccinating Veterans Experiencing Homelessness for COVID-19: Healthcare and Housing Service Providers’ Perspectives

“…Thus, addressing access barriers and reducing vaccine hesitancy among this vulnerable population is a public health priority for the VA [ 21 ]. The present study found that an average of 50% of Veterans receiving care and services from HPACT clinics and GPD organizations were vaccinated for COVID-19, which is consistent with findings from similar studies in the U.S. and abroad [ 8 , 12 , 22 – 25 ].…”

COVID-19 vaccine coverage and factors associated with vaccine uptake among 23 247 adults with a recent history of homelessness in Ontario, Canada: a population-based cohort study

“…Although it is not possible to fully ascertain the mechanisms behind this lagged vaccination coverage from the study findings alone, past work has identified a range of hesitancy factors related to obtaining vaccination in people experiencing homelessness, including fear or mistrust of the vaccine, misinformation spread in media, uncertainties about personal risk of COVID-19, and elements related to access to health-care structures and trust within the patient–provider relationship. 21 , 23 , 24 , 31 , 32 Furthermore, systematic structural barriers commonly faced by people experiencing homelessness 33 possibly also acted as obstacles to COVID-19 vaccination in the study population. For instance, during the study period, many of the centralised provincial vaccination clinics required advanced scheduling of appointments through online websites or portals.…”

“…Although the causal mechanisms of this association are not fully clear, the literature exploring COVID-19 vaccination approaches in people experiencing homelessness has outlined that trust and relationship building with this population is central to a successful vaccination strategy. 30 , 32 , 33 As a historically marginalised population, people experiencing homelessness face considerable and ongoing barriers towards accessing health-care services 34 that have only been further exacerbated by the pandemic. 35 Community-based primary health-care models that provide priority populations such as people experiencing homelessness with more accessible avenues to health care (eg, community health centres and outreach teams) should be further investigated and leveraged to support vaccination efforts in people experiencing homelessness, along with other targeted vaccination interventions (ie, mobile vaccination clinics at encampments, as well as opioid replacement therapy and safe injection locations).…”

COVID-19 Vaccine Acceptability and Financial Incentives among Unhoused People in Los Angeles County: a Three-Stage Field Survey

“…Because this study used a convenience sample and did not measure demographic characteristics of participants, the generalizability of these results may be limited beyond HFH clients, and relevant differences in attitudes toward vaccination across demographic groups could not be captured. Unhoused people in Los Angeles are certainly not homogenous, and demographic differences in vaccine uptake are key metrics locally and more broadly [ 10 ]. We briefly piloted including demographic questions (age, gender identity, race, and ethnicity) after the vaccine readiness question, but clients were often unwilling to answer these questions.…”

“…Early studies suggest that up to half of unhoused people may be hesitant about getting vaccinated, compared to an estimated 30% of the general population [ 6 , 7 ]. Common reasons for hesitancy include mistrust of the government as well as concerns about side effects, safety, and long-term health complications [ 6 , 8 – 10 ].…”