Impact of an Education Intervention on COVID-19 Vaccine Hesitancy in a Military Base Population.

BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccine hesitancy is a major impediment to achieving herd immunity and overcoming the current pandemic. Our aim was to decrease the prevalence of vaccine hesitancy through an education intervention. METHOD: An education intervention, consisting of a PowerPoint presentation addressing the two mRNA COVID-19 vaccine concerns/myths and a question and answer panel comprising health care providers from various specialties, was implemented to address vaccine hesitancy among personnel associated with Wright-Patterson Air Force Base through a series of virtual and in-person seminars. Participants completed a post-seminar survey as a retrospective self-assessment to identify attitudes and views surrounding vaccine hesitancy and the impact of the education intervention. Chi-squared test was used to examine relationships between categorical variables, and multiple logistic regression was used to identify risk factors for vaccine hesitancy pre- and post-seminar. All analyses were done using SPSS Statistics Version 25.0 (IBM, Armonk, NY). Institutional Review Board approval was not obtained before this study as it began as a non-research initiative and received non-research determination post hoc. RESULTS: Five hundred participants completed the survey. Mean age was 44.7 years with 13.4 and 86.6% medical and non-medical personnel, respectively. Nearly all (98.8%) had not received their first shot of the vaccine series. 402 (80.9%) were receptive to vaccination, and 95 (19.1%) were hesitant post-seminar. Of the 139 participants who reported they were initially hesitant after our intervention, 50 (36%) indicated that they were now receptive to the vaccine, while 89 (64%) remained hesitant. Of those 50, 48 (96%) had moderate to great amount of trust in COVID-19 vaccine information presented by physicians/other providers. Six respondents who wanted the vaccine before the intervention no longer wanted the vaccine. A medical occupation (OR = 4.85, 95% CI = 2.63-8.96, P < .001), little or no trust in COVID-19 vaccine information from physicians/other providers (OR = 19.48, 95% CI = 7.31-51.90, P < 0.001), and being age 30 or younger (OR = 1.81, 95% CI = 1.02-3.2, P = 0.041) were independent predictors of vaccine hesitancy. Trust in providers was a significant factor in change of intent from vaccine hesitant to receptive post-intervention (OR 0.13, 95% CI = 0.03-0.59, P = .008). Age and occupation were not significant factors associated with change in intent. CONCLUSION: Our education intervention was effective in reducing COVID-19 vaccine hesitancy in a military base population. Study limitations include applications toward other military and non-military populations, the possibility of nonresponse bias, and absence of prior validated interventions. Area for future studies includes improvement upon educational intervention, development of other effective methods, and application of intervention in other populations.

Perceptions and Concerns Regarding COVID-19 Vaccination in a Military Base Population.

INTRODUCTION: Safe and effective vaccines against severe acute respiratory syndrome-associated coronavirus 2 are essential tools in the fight against the coronavirus disease 2019  (COVID-19) pandemic. However, hesitancy to vaccination is a major barrier to achieving herd immunity, particularly among a population working on a military base. To better understand the perceptions and concerns of these individuals, a voluntary survey was conducted. MATERIALS AND METHODS: An interactive, online survey was constructed and disseminated to individuals associated with Wright-Patterson Air Force Base (WPAFB) in Dayton, OH. Survey participation was voluntary with responses collected over the initial weeks in which WPAFB began to distribute COVID-19 vaccines in a series of phases. Although initially designed to collect demographic data and identify reasons for potential vaccine hesitancy among WPAFB 88th Medical Group personnel, the study population was expanded to include all WPAFB-affiliated personnel at the direction of base leadership. The chi-squared test was used to examine the relationships between categorical variables, while multivariable logistic regression was used to assess age and occupation as independent risk factors for vaccine hesitancy. RESULTS: A total of 816 individuals completed the survey, of whom 22.7% (n = 185) self-identified as vaccine hesitant (VH). The VH group had a lower mean age than the not vaccine hesitant (NVH) group (39.3 ± 14.2 vs. 45.9 ± 13.4, P < .001). Respondents whose occupation was medical were more likely to be VH than their non-medical colleagues (49% vs. 18%, P < .001). The VH group was more concerned about short-term side effects (43% vs. 26%, P < .001), long-term side effects (82% vs. 50%, P < 0.001), vaccine effectiveness (23% vs. 5%, P < .001), vaccine making them feel sick (22% vs. 13%, P = .002), being infected with COVID-19 from the vaccine (10% vs. 5%, P = 0.008), and worry about misinformation/political agenda (43% vs. 31%, P = 0.003). Younger respondents and medical personnel were more likely to be concerned about long-term side effects and vaccine effectiveness, and the younger group was also more likely to be concerned about pregnancy/breastfeeding issues and worry about misinformation/political agenda. Age (younger vs. older, odds ratio 2.15) and occupation (medical vs. non-medical, odds ratio 3.74) were independent risk factors for vaccine hesitancy. The NVH group was more likely to recommend the COVID-19 vaccine to a friend or family member than the VH group (93% vs. 20%, P < .001) as were the older age group (79% vs. 67%, P = .001) and non-medical personnel (81% vs. 52%, P < .001). CONCLUSIONS: Younger age and medical occupation were independent risk factors for vaccine hesitancy and these individuals were less likely to recommend vaccination to a friend or family member. We also identified several key concerns related to vaccination hesitancy, in particular those related to short- and long-term side effects, and the spread of misinformation. Among military personnel, these findings carry important implications that may negatively impact mission readiness, a matter that merits further investigation. Our COVID-19 vaccination hesitancy findings can be used to guide targeted interventions at future vaccination campaigns in a military population.

Identifying Gender Barriers for Colorectal Cancer Screening and Assessing the Need for a Multigender Endoscopy Team: A Prospective Multicenter Study.

INTRODUCTION: Gender preferences have been reported as a barrier to colorectal cancer screening, particularly among women. We aim to identify the role of patients' gender preferences for endoscopists and endoscopy team members, with the effect of age-related and regional differences. METHODS: We conducted an anonymous, voluntary survey of all adult outpatients presenting at our endoscopy centers before their procedures. RESULTS: We received 2,138 (1,207 women, 905 men, and 26 undisclosed; 50% urban and 50% rural) completed surveys. The majority of the patients (89%) did not have an endoscopist gender preference, while 8% preferred a same-gender endoscopist, and 2% preferred an opposite gender endoscopist. Among patients who expressed a gender preference, men more commonly preferred a same-gender endoscopist than women (91% vs 67%, P < 0.05). More patients preferred a same-gender endoscopy team member than a same-gender endoscopist (17% vs 8%, P < 0.05), and women more commonly preferred a same-gender endoscopy team member than men (26% vs 6%, P < 0.05). Most patients who expressed same-gender endoscopist preference were between the ages of 50-69 years as compared to other age groups (P < 0.05). Of the urban patients, 9% expressed a same-gender endoscopist preference and 3% expressed an opposite gender preference, compared with 7% and 2% of rural patients (P < 0.05). Among patients with any endoscopist gender preference, rural patients were more willing to wait longer (41% vs 21%, P < 0.05), whereas urban patients were willing to pay more (64% vs 14%, P < 0.05) to have their preferences met. DISCUSSION: Contrary to previous studies, most patients did not have an endoscopist gender preference. Interestingly, men had more same-gender endoscopist preference, whereas women had more same-gender endoscopy team member preference. Age-related and regional differences exist among patients' gender preferences for their endoscopist and endoscopy team member, and addressing these preferences while creating an environment of a multigender endoscopy team may be beneficial in improving colorectal cancer screening.