Abstract

Veterans experiencing homelessness are particularly at risk from infection and transmission from COVID-19, and vaccines offer a promising avenue toward reducing that risk. However, little is understood about vaccine acceptance within the homeless population, particularly Veterans experiencing homelessness, who comprise a disproportionate share of that population. The cultural roots of vaccine hesitancy among active-duty military members and Veterans are even less understood. This study used semi-structured interviews to explore the role of military identity in shaping the vaccination attitudes of 20 Veterans experiencing homelessness enrolled in U.S. Department of Veterans Affairs’ (VA) transitional housing programs. Over half of the Veteran respondents mentioned their military experience during interviews about the COVID-19 vaccines. In these discussions, they cited mandatory vaccines in the military, military identity, and distrust of the military or government. Distrust was cited by most refusing the vaccine, while mandatory vaccines in the military were cited by most accepting the vaccine. Military identity, culture, and experience influence the risk-benefit reasoning that man Veterans in VA homeless programs undertake when deciding whether to accept the COVID-19 vaccine. A more nuanced understanding of military culture’s effect on Veterans experiencing homelessness is vital in designing messages and strategies that encourage vaccine uptake.

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