Exploring preventive care practices among unvaccinated individuals in the United States during the COVID-19 pandemic

Abstract

IntroductionBuilding on a Canadian study associating unvaccinated individuals to increased car accidents, we examined the relationship between COVID-19 vaccination status and US preventive care practices. MethodsWe queried the 2021 National Health Interview Survey. First, we fitted a model to identify respondent-level factors associated with receipt of at least one COVID-19 vaccination. Second, we fitted a survey-weighted logistic regression model adjusted for respondent-level characteristics to examine whether the receipt of at least one COVID-19 vaccination predicted the receipt of preventive care services. Preventive care services assessed included serum cholesterol, glucose, and blood pressure measurements, as well as guideline-concordant cancer screening including breast, cervical, colorectal, and prostate cancer screening. ResultsFactors predicting receipt of COVID-19 vaccination were age (adjusted Odds Ratio (aOR) 1.03; 95 % confidence interval (CI) [1.03–1.03]), Hispanic (aOR 1.25; 95 % CI [1.08–1.44]), and non-Hispanic Asian (aOR 3.52; 95 % CI [2.74–4.52]) ethnicity/race, and history of cancer (aOR 1.61; 95 % CI [1.13–2.30]). Unvaccinated respondents were less likely to have received serum cholesterol (aOR 0.69; 95 % CI [0.50–0.70), serum glucose (aOR 0.65; 95 % CI [0.56–0.75]), or blood pressure measurements (aOR 0.47; 95 % CI [0.33–0.66]); and were less likely to have received breast cancer (aOR 0.35; 95 % CI [0.25–0.48]), colorectal cancer (aOR 0.52; 95 % CI [0.46–0.60]) and prostate cancer screening (aOR 0.61; 95 % CI [0.48–0.76]). There was no significant association between unvaccinated respondents receiving cervical cancer screening (aOR 0.96; 95 % CI [0.81–1.13]; p = 0.616). ConclusionNon-receipt of COVID-19 vaccination was associated with non-receipt of preventive care services including cancer screening. Further studies are needed to assess if this association is due to system-level factors or reflects a general distrust of medical preventive care amongst this population.