Abstract
(1) Background: COVID-19 vaccination hesitancy is a threat for fragile patients. We aimed to evaluate COVID-19 vaccination hesitancy and its reasons in a population of liver transplant (LT) recipients. (2) Methods: In February 2021, a questionnaire on COVID-19 vaccines was sent to LT patients followed at our liver transplant outpatient clinic in Milan, Italy. Sociodemographic and clinical characteristics were recorded. Patients were defined as willing, hesitant, or refusing and their reasons were investigated. Associations between baseline characteristics and willingness were evaluated. Since March 2021, when the COVID-19 vaccines became available for LT candidates and recipients in Italy, the entire cohort of LT recipients was contacted by phone and called for vaccination, and the rate of refusals recorded. (3) Results: The web-based survey was sent to 583 patients, of whom 190 responded (response rate of 32.6%). Among the respondents to the specific question about hesitancy (184), 157 (85.3%) were willing to be vaccinated against COVID-19, while 27 (14.7%) were hesitant. Among the hesitant, three were totally refusing, for a refusal rate of 1.6%. Thirteen hesitant patients (48.1%) answered that their COVID-19 vaccination hesitancy was influenced by being a transplant recipient. The fear of adverse effects was the main reason for refusal (81.5%). Of the 711 LT patients followed at our center, 668 got fully vaccinated, while 43 (6.1%) of them refused the scheduled vaccination. (4) Conclusions: Most patients accepted COVID-19 vaccines, although 6.1% refused the vaccine. Since it is crucial to achieve adequate vaccination of LT patients, it is very important to identify the reasons influencing COVID-19 vaccination hesitancy so that appropriate and targeted communication strategies can be established and specific vaccination campaigns further implemented.
Highlights
IntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA-based and viral vector-based vaccines are approved for the general population [1,2]
The patients were classified as willing, hesitant, or refusing to accept COVID-19 vaccination, and the reasons and possible factors influencing vaccination hesitancy were investigated with multiple-choice questions
The great majority of the respondent liver transplant (LT) recipients were adhering to their treatment
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA-based and viral vector-based vaccines are approved for the general population [1,2]. These vaccines provide effective protection against coronavirus disease 19 (COVID-19) [3,4]. The term “vaccination hesitancy” refers to the “delay in acceptance or refusal of vaccination despite availability” according to the World Health Organization [WHO] Strategic Advisory Group of Experts on Immunization [SAGE] Working Group on Vaccine Hesitancy [5]. Even before the COVID-19 pandemic, vaccination hesitancy was recognized by the WHO as being one of the 10 threats to global health, since vaccine uptake has been declining worldwide [6]
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