COVID-19 vaccine hesitancy among rural Oklahomans.

INTRODUCTION: COVID-19 vaccination is widely recommended as a prevention strategy; however, vaccine uptake is disproportionately lower among rural Americans compared to their urban counterparts. Development of public health activities to address the rural-urban vaccine gap requires an understanding of determinants of vaccine hesitation. The present study explores perceptions of and barriers to COVID-19 vaccination among rural Oklahomans. METHODS: Between March and May 2021, 222 residents, unvaccinated for COVID-19, within rural Oklahoma counties completed a cross-sectional, online questionnaire to qualitatively assess perceptions, benefits, and concerns regarding getting vaccinated for COVID-19. RESULTS: Approximately two-fifths of rural respondents in the present study were hesitant to get vaccinated, even when a vaccine was made available to them. Major factors included limited knowledge and understanding about the vaccine, including potential side-effects and long-term complications, as well as skepticism surrounding COVID-19 vaccine development and efficacy. Among the potential perceived benefits of vaccination were protecting the health of vulnerable individuals and the ability to return to normal day-to-day activities. CONCLUSION: Increases in COVID-19 cases and deaths in rural areas are expected to continue as new variants are introduced within communities. The present findings highlight the need for the development of culturally tailored vaccine information, to be disseminated by local leaders within rural communities.

Simultaneous Use of Alcohol and Electronic Nicotine Delivery Systems among College Students: Vaping History, Motivations for Use, and Outcome Expectancies.

Introduction: Simultaneous polydrug use of electronic nicotine delivery systems (ENDS) and alcohol among college students is not well understood despite high rates of vaping and alcohol use among this population. The current study examined rates of simultaneous use and compared demographic characteristics, vaping history, motivations for initiating use, and outcome expectancies based on polydrug use status. Methods: An online and paper-and pencil questionnaire was administered to undergraduate students at a university in the northeast of the U.S. Purposive sampling strategies were used and a raffle was offered to incentivize participation. Results: Simultaneous polydrug use was prevalent in the sample of 670 college students, with 55.6% reporting simultaneous and non-simultaneous use, 34.0% reporting simultaneous use only, and 10.4% reporting non-simultaneous use only. An examination of differences based on polydrug use status indicated that students who reported simultaneous and non-simultaneous use were more likely to be males, report vaping daily, and endorse a wide range of motivations for use. Students who engaged in simultaneous use only were more likely to be females, indicate a social contextual-related motivation for initiating use, and had higher scores on appetite control, emotion regulation, and taste sensation outcome expectancies. Students who engaged in non-simultaneous use only were more likely to be nonwhite students and report the lowest expectation of health risks. Conclusions: The findings reveal differences based on simultaneous polydrug use status that can be informative in the development of contextually relevant prevention programming. Future research is needed to further explore simultaneous use of ENDS and alcohol.