Comorbidities and confusion: addressing COVID-19 vaccine access and information challenges.

Objective: Early in the coronavirus disease 2019 (COVID-19) pandemic, evidence emerged that individuals with chronic and immunocompromising conditions faced increased risk of severe infection, including death. The Australian Government and public health authorities prioritised these citizens' access to vaccines, including them in phase 1b of the rollout from 22 March 2021. Given the rapidly evolving knowledge and advice, we sought to understand what people with comorbidities understood about their eligibility, where they obtained information, and their experiences interfacing with the program.

Methods: Through the mixed methods project Coronavax, we conducted semi-structured in-depth interviews with eight West Australians aged under 60 who signed up to the study's webpage and declared comorbidities pertinent to serious COVID-19 complications. Interviews were conducted during January-April 2022, audio-recorded, transcribed in full, and analysed in NVivo 20 using inductive methods. We validated participants' accounts of state government actions with a representative in person and in writing.

Results: We identified access and informational barriers - and a lack of understanding - about vaccine eligibility amongst West Australians with comorbidities. Amid a rapidly changing landscape of knowledge with subsequent policy implications, this group received insufficient information for their needs for understanding their place in the immunisation program.

Conclusions: Fast-changing knowledge about vaccines creates communication challenges for government and health professionals. We identify an urgent need to develop, pilot, and evaluate strategies for providing vaccination information in routine and pandemic settings.