Variables Associated with Coronavirus Disease 2019 Vaccine Hesitancy Amongst Patients with Neurological Disorders

doi:10.3390/idr13030072

. 2021 Aug 30;13(3):763-810.

doi: 10.3390/idr13030072.

Variables Associated with Coronavirus Disease 2019 Vaccine Hesitancy Amongst Patients with Neurological Disorders

Arash Ghaffari-Rafi^{1

2}, Kimberly Bergenholtz Teehera², Tate Justin Higashihara², Frances Tiffany Cava Morden², Connor Goo², Michelle Pang², Cori Xiu Yue Sutton², Kyung Moo Kim², Rachel Jane Lew², Kayti Luu², Shaina Yamashita³, Catherine Mitchell⁴, Enrique Carrazana^{2

4}, Jason Viereck^{2

4}, Kore Kai Liow^{2

4}

Affiliations

¹ Department of Neurological Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA.
² John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI 96813, USA.
³ University of Hawai'i at Mānoa, Honolulu, HI 96822, USA.
⁴ Brain Research, Innovation and Translation Lab, Hawaii Pacific Neuroscience, Honolulu, HI 96817, USA.

PMID: 34562997
PMCID: PMC8482072
DOI: 10.3390/idr13030072

Variables Associated with Coronavirus Disease 2019 Vaccine Hesitancy Amongst Patients with Neurological Disorders

Arash Ghaffari-Rafi et al. Infect Dis Rep. 2021.

. 2021 Aug 30;13(3):763-810.

doi: 10.3390/idr13030072.

Authors

Affiliations

¹ Department of Neurological Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA.
² John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI 96813, USA.
³ University of Hawai'i at Mānoa, Honolulu, HI 96822, USA.
⁴ Brain Research, Innovation and Translation Lab, Hawaii Pacific Neuroscience, Honolulu, HI 96817, USA.

PMID: 34562997
PMCID: PMC8482072
DOI: 10.3390/idr13030072

Abstract

Introduction: Given that the success of vaccines against coronavirus disease 2019 (COVID-19) relies on herd immunity, identifying patients at risk for vaccine hesitancy is imperative-particularly for those at high risk for severe COVID-19 (i.e., minorities and patients with neurological disorders).

Methods: Among patients from a large neuroscience institute in Hawaii, vaccine hesitancy was investigated in relation to over 30 sociodemographic variables and medical comorbidities, via a telephone quality improvement survey conducted between 23 January 2021 and 13 February 2021.

Results: Vaccine willingness (n = 363) was 81.3%. Univariate analysis identified that the odds of vaccine acceptance reduced for patients who do not regard COVID-19 as a severe illness, are of younger age, have a lower Charlson Comorbidity Index, use illicit drugs, or carry Medicaid insurance. Multivariable logistic regression identified the best predictors of vaccine hesitancy to be: social media use to obtain COVID-19 information, concerns regarding vaccine safety, self-perception of a preexisting medical condition contraindicated with vaccination, not having received the annual influenza vaccine, having some high school education only, being a current smoker, and not having a prior cerebrovascular accident. Unique amongst males, a conservative political view strongly predicted vaccine hesitancy. Specifically for Asians, a higher body mass index, while for Native Hawaiians and other Pacific Islanders (NHPI), a positive depression screen, both reduced the odds of vaccine acceptance.

Conclusion: Upon identifying the variables associated with vaccine hesitancy amongst patients with neurological disorders, our clinic is now able to efficiently provide ancillary COVID-19 education to sub-populations at risk for vaccine hesitancy. While our results may be limited to the sub-population of patients with neurological disorders, the findings nonetheless provide valuable insight to understanding vaccine hesitancy.

Keywords: Hawaii; coronavirus disease 2019; demographic; neurological disorders; quality improvement; risk factors; socioeconomic; vaccine hesitancy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Figure 1**
Sampled patients for survey.

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[1] Szilagyi P.G., Thomas K., Shah M.D., Vizueta N., Cui Y., Vangala S., Kapteyn A. National Trends in the US Public’s Likelihood of Getting a COVID-19 Vaccine—1 April to 8 December, 2020. JAMA. 2021;325:396–398. doi: 10.1001/jama.2020.26419. - DOI - PMC - PubMed

[2] Szilagyi P.G., Thomas K., Shah M.D., Vizueta N., Cui Y., Vangala S., Kapteyn A. National Trends in the US Public’s Likelihood of Getting a COVID-19 Vaccine—1 April to 8 December, 2020. JAMA. 2021;325:396–398. doi: 10.1001/jama.2020.26419. - DOI - PMC - PubMed

[3] MacDonald N.E. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33:4161–4164. doi: 10.1016/j.vaccine.2015.04.036. - DOI - PubMed

[4] MacDonald N.E. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33:4161–4164. doi: 10.1016/j.vaccine.2015.04.036. - DOI - PubMed

[5] Mello M.M., Silverman R.D., Omer S.B. Ensuring Uptake of Vaccines against SARS-CoV-2. N. Engl. J. Med. 2020;383:1296–1299. doi: 10.1056/NEJMp2020926. - DOI - PubMed

[6] Mello M.M., Silverman R.D., Omer S.B. Ensuring Uptake of Vaccines against SARS-CoV-2. N. Engl. J. Med. 2020;383:1296–1299. doi: 10.1056/NEJMp2020926. - DOI - PubMed

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[8] Hollmeyer H., Hayden F., Mounts A., Buchholz U. Review: Interventions to increase influenza vaccination among healthcare workers in hospitals. Influenza Other Respir. Viruses. 2013;7:604–621. doi: 10.1111/irv.12002. - DOI - PMC - PubMed

[9] Ro J.M., Yee A.K. Out of the shadows: Asian Americans, Native Hawaiians, and Pacific Islanders. Am. J. Public Health. 2010;100:776–778. doi: 10.2105/AJPH.2010.192229. - DOI - PMC - PubMed

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Variables Associated with Coronavirus Disease 2019 Vaccine Hesitancy Amongst Patients with Neurological Disorders

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Variables Associated with Coronavirus Disease 2019 Vaccine Hesitancy Amongst Patients with Neurological Disorders

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