Predictors of COVID-19 Vaccination among Veterans Experiencing Homelessness.

Michelle D Balut,Claudia Der-Martirosian,Aram Dobalian,Karen Chu,June L Gin

doi:10.3390/vaccines9111268

Michelle D Balut, Claudia Der-Martirosian + Show 3 more

Open Access

https://doi.org/10.3390/vaccines9111268

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Abstract

Sufficient uptake of the COVID-19 vaccine is key to slowing the spread of the coronavirus among the most vulnerable in society, including individuals experiencing homelessness. However, COVID-19 vaccination rates among the Veteran homeless population are currently unknown. This study examines the COVID-19 vaccination rate among homeless Veterans who receive care at the U.S. Department of Veterans Affairs (VA), and the factors that are associated with vaccine uptake. Using VA administrative and clinical data, bivariate and multivariate analyses were conducted to identify the sociodemographic, health-related, and healthcare and housing services utilization factors that influenced COVID-19 vaccine uptake during the first eight months of the vaccine rollout (December 2020–August 2021). Of the 83,528 Veterans experiencing homelessness included in the study, 45.8% were vaccinated for COVID-19. Non-white, older Veterans (65+), females, those who received the seasonal flu vaccine, and Veterans with multiple comorbidities and mental health conditions were more likely to be vaccinated. There was a strong association between COVID-19 vaccination and Veterans who utilized VA healthcare and housing services. VA healthcare and homeless service providers are particularly well-positioned to provide trusted information and overcome access barriers for homeless Veterans to receive the COVID-19 vaccine.

Highlights

Infectious disease outbreaks often disproportionately impact those with underlying health conditions and individuals experiencing poverty, marginalization, and discrimination [1,2].Amidst the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, people who experience homelessness are at risk of contracting and transmitting COVID-19 due to their transient nature and dependency on homeless shelters and other social service facilities, where overcrowding and high population turnover are common [3,4]
With regard to Housing and Urban Development (HUD)-VASH, Health Care for Homeless Veterans (HCHV), and Grant and Per Diem (GPD) programs, the distribution of Veterans experiencing homelessness who participated in these programs were: 48.6%, 25.2%, and 9.4%, respectively
This study found that 45.8% of Veterans experiencing homelessness across the U.S have received at least one dose of the COVID-19 vaccine, which is below the vaccination rates for both the general adult (64.3%) and overall Veteran populations (51.5%)

Summary

Introduction

Amidst the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, people who experience homelessness are at risk of contracting and transmitting COVID-19 due to their transient nature and dependency on homeless shelters and other social service facilities, where overcrowding and high population turnover are common [3,4]. This population is more likely to include people of color, those with chronic mental and physical conditions, and those with limited access to healthcare, all of which may lead to an increased risk of morbidity or mortality if they develop.

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