Search

Background: Individuals with comorbid conditions have been disproportionately affected by COVID-19. Since regulatory trials of COVID-19 vaccines excluded those with immunocompromising conditions, few patients with cancer and autoimmune diseases were enrolled. With limited vaccine safety data available, vulnerable populations may have conflicted vaccine attitudes., Objective: We assessed the prevalence and independent predictors of COVID-19 vaccine hesitancy and acceptance among individuals with serious comorbidities and assessed self-reported side effects among those who had been vaccinated., Methods: We conducted a cross-sectional, 55-item, online survey, fielded January 15, 2021 through February 22, 2021, among a random sample of members of Inspire, an online health community of over 2.2 million individuals with comorbid conditions. Multivariable regression analysis was utilized to determine factors independently associated with vaccine hesitancy and acceptance., Results: Of the 996,500 members of the Inspire health community invited to participate, responses were received from 21,943 individuals (2.2%). Respondents resided in 123 countries (United States: 16,277/21,943, 74.2%), had a median age range of 56-65 years, were highly educated (college or postgraduate degree: 10,198/17,298, 58.9%), and had diverse political leanings. All respondents self-reported at least one comorbidity: cancer, 27.3% (5459/19,980); autoimmune diseases, 23.2% (4946/21,294); chronic lung diseases: 35.4% (7544/21,294). COVID-19 vaccine hesitancy was identified in 18.6% (3960/21,294), with 10.3% (2190/21,294) declaring that they would not, 3.5% (742/21,294) stating that they probably would not, and 4.8% (1028/21,294) not sure whether they would agree to be vaccinated. Hesitancy was expressed by the following patients: cancer, 13.4% (731/5459); autoimmune diseases, 19.4% (962/4947); chronic lung diseases: 17.8% (1344/7544). Positive predictors of vaccine acceptance included routine influenza vaccination (odds ratio [OR] 1.53), trust in responsible vaccine development (OR 14.04), residing in the United States (OR 1.31), and never smoked (OR 1.06). Hesitancy increased with a history of prior COVID-19 (OR 0.86), conservative political leaning (OR 0.93), younger age (OR 0.83), and lower education level (OR 0.90). One-quarter (5501/21,294, 25.8%) had received at least one COVID-19 vaccine injection, and 6.5% (1390/21,294) completed a 2-dose series. Following the first injection, 69.0% (3796/5501) self-reported local reactions, and 40.0% (2200/5501) self-reported systemic reactions, which increased following the second injection to 77.0% (1070/1390) and 67.0% (931/1390), respectively., Conclusions: In this survey of individuals with serious comorbid conditions, significant vaccine hesitancy remained. Assumptions that the most vulnerable would automatically accept COVID-19 vaccination are erroneous and thus call for health care team members to initiate discussions focusing on the impact of the vaccine on an individual's underlying condition. Early self-reported side effect experiences among those who had already been vaccinated, as expressed by our population, should be reassuring and might be utilized to alleviate vaccine fears. Health care-related social media forums that rapidly disseminate accurate information about the COVID-19 vaccine may play an important role., (©Richard Tsai, John Hervey, Kathleen Hoffman, Jessica Wood, Jennifer Johnson, Dana Deighton, Donald Clermont, Brian Loew, Stuart L Goldberg. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 05.01.2022.)

We examined the perceived impact of the COVID-19 pandemic on sexual health, sexual behaviour, well-being, and access to sexual health services among university students in Canada. Between December 2020 and January 2021, 1504 university students across Canada completed an online survey focused on overall sexual health, well-being, solitary sexual behaviours, partnered sexual interactions, and access to sexual health services. The survey was designed by the Sex Information & Education Council of Canada and administered by the Leger polling company. Reported levels of overall sexual health were high. Cisgender women reported significantly greater scores of COVID-19—related stress compared to cisgender men; LGBQ+ students had higher levels of stress compared to heterosexual participants. Overall, solitary sexual behaviours (i.e., masturbation, porn use, vibrator use) remained unchanged or were perceived to increase compared to the time before the pandemic. Cisgender men reported higher scores (i.e., greater perceived increases) on masturbation and porn use than cisgender women. Frequency of sex with casual partners was perceived as similar or lower than what was usual before the pandemic, and most participants did not engage in sex where the close personal contact put them or their partner at risk for COVID-19. Declines in access were reported for all sexual health care services surveyed, with cisgender women and students of colour more likely to report decreased access to services. Results highlight the need for targeted public health messaging regarding sexual behaviour, investment in sexual health services, and supports tailored to the needs of women, LGBTQ+ individuals, and people of colour. [ABSTRACT FROM AUTHOR]