Perceptions About Influenza and COVID-19 Vaccines Among People With CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.

Abstract

RATIONALE & OBJECTIVE Vaccine uptake among individuals with chronic kidney disease (CKD) is suboptimal. Understanding the perceptions associated with vaccine hesitancy can help inform programs aimed at addressing these concerns. STUDY DESIGN Cross-sectional survey. SETTING & PARTICIPANTS A subset of participants from the Chronic Renal Insufficiency Cohort (CRIC) Study, recruited from three study sites. EXPOSURES Participants' perceptions about influenza and COVID-19 infection risks, benefits and harms of vaccines, vaccine skepticism, access barriers, and cues to action, according to the Health Belief Model. OUTCOME Influenza and COVID-19 vaccine hesitancy, defined as being uncertain about or not planning to receive a future dose of these vaccines. ANALYTIC APPROACH Responses were measured on a 5-point Likert scale (1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, 5 = strongly disagree). Linear regression models were used to analyze differences in mean Likert scale scores between participants with and without vaccine hesitancy. RESULTS Between July 2022 and June 2023, 278 CRIC participants completed the survey, of whom 47 (16.9%) and 46 (16.8%) had influenza and COVID-19 vaccine hesitancy, respectively. Linear regression models identified key perceptions associated with vaccine hesitancy, including perceived harms of the vaccines (e.g., the vaccine causes influenza; ΔMean Likert scale 1.25 [95% CI, 0.96 to 1.55]) and vaccine skepticism (e.g., benefits of the influenza vaccine are exaggerated; 0.96 [95% CI, 0.65 to 1.26]). Perceived benefits were negatively associated with vaccine hesitancy (e.g., influenza vaccines prevent serious illness; -0.93 [-1.23 to -0.62]). More than 40% perceived that they were not at risk of influenza, but this perception was not associated with vaccine hesitancy (0.02 [-0.35 to 0.40]). These findings were overall consistent for COVID-19, although vaccine skepticism was more prevalent and more strongly associated with vaccine hesitancy. LIMITATIONS The study population consisted of individuals with CKD who were enrolled in a cohort study and voluntarily responded to the survey. CONCLUSIONS Among individuals with CKD, perceptions of vaccine harms and vaccine skepticism were significant factors contributing to vaccine hesitancy. Improved dissemination of accurate vaccine information through tailored patient education initiatives may enhance vaccination uptake in this population.