Determinants of COVID 19 Vaccine Uptake Among People with Substance Use Disorder in Türkiye
Yıl 2025,
Cilt: 12 Sayı: 1, 178 - 185, 26.03.2025
Osman Hasan Tahsin Kılıç
,
Aykut Aydoğdu
,
Zehra Nur Bayram
,
Nida Üstün
,
Nazlı Deniz Munis
,
İlayda İncebıyık
,
Aysel Başer
Öz
Aim; The COVID-19 pandemic has highlighted significant socioeconomic and health disparities, particularly for socially vulnerable populations such as individuals with Substance Use Disorder (SUD). Despite the heightened risk of severe COVID-19 outcomes, individuals with SUD demonstrated higher vaccine hesitancy and lower vaccination rates compared to the general population. This study aimed to assess the vaccination status of SUD patients in Türkiye and explore factors influencing vaccine uptake.
Method; The cross-sectional study included a sample of individuals diagnosed with SUD, with data on COVID-19 infection and vaccination retrieved from digital health records. Sociodemographic characteristics, paranoid ideation, and vaccine confidence were assessed using structured forms.
Results; The findings suggest that vaccine confidence is the primary determinant of vaccination status, while other sociodemographic factors showed no significant relationship with vaccination.
Conclusion; These insights underscore the need for tailored public health interventions to boost vaccine confidence, particularly in addressing healthcare distrust and logistical barriers. Further research is recommended to better understand the low vaccine uptake in this high-risk group and develop effective strategies for prevention.
Etik Beyan
The Ethics Committee of İzmir Democracy University Buca Seyfi Demirsoy Education and Research Hospital approved the research protocol (Approval Date: 31.01.2024, Approval No: 2024/235). All subjects were informed of the purpose of the study and provided documented informed consent. All investigations were conducted in strict adherence to the Declaration of Helsinki.
Teşekkür
It was also presented as an oral presentation (S-52) at the TPD Annual Meeting and the 2nd International 26th National Clinical Education Symposium held between May 9-12, 2024.
Kaynakça
- 1. Volkow, N.D., Blanco, C., Research on substance use disorders during the COVID-19 pandemic, Journal of Substance Abuse Treatment, 2021, 129, 108385. doi: 10.1016/j.jsat.2021.108385.
- 2. Mah, J.C., Penwarden, J.L., Pott, H., Theou, O., Andrew, M.K., Social vulnerability indices: a scoping review, BMC Public Health, 2023, 23, 1253. doi:10.1186/s12889-023-16097-6.
- 3. Wang, Q.Q., Kaelber, D.C., Xu, R., Volkow, N.D., COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States, Molecular Psychiatry, 2021, 26, 30-39.
- 4. Karavolis, Z., Thacker, E., Fabian, T., Douaihy, A., Reynolds, M., Kirisci, L., Tarter, R., Pharmacist-implemented intervention to surmount COVID-19 vaccination hesitancy in adults with substance use disorders, American Journal of Health-System Pharmacy, 2024, zxae095. doi:10.1093/ajhp/zxae095.
- 5. Cepeda, J.A., Feder, K.A., Astemborski, J., Schluth, C., Kirk, G.D., Mehta, S.H., Genberg, B.L., COVID-19 vaccine hesitancy and vaccination status in a community-based cohort of people who inject drugs in Baltimore, Maryland, March-June 2021, Public Health Reports, 2022, 137, 1031-1040. doi:10.1177/00333549221110299.
- 6. Andrade, G., COVID-19 vaccine hesitancy, conspiracist beliefs, paranoid ideation and perceived ethnic discrimination in a sample of university students in Venezuela, Vaccine, 2021, 39(47), 6837-6842. doi: 10.1016/j.vaccine.2021.10.037.
- 7. Swami, V., Weis, L., Lay, A., Barron, D., Furnham, A., Associations between belief in conspiracy theories and the maladaptive personality traits of the personality inventory for DSM-5, Psychiatry Research, 2016, 236, 86-90.
- 8. Matheson, S.L., Laurie, M., Laurens, K.R., Substance use and psychotic-like experiences in young people: a systematic review and meta-analysis, Psychological Medicine, 2023, 53, 305-319.
- 9. Ellilä, V., Levola, J., Denissoff, A., Partanen, M., Niemelä, S., Psychotic-like experiences and concurrent substance use among people who use new psychoactive substances, Substance Use & Misuse, 2023, 58, 1606-1614. doi:10.1080/10826084.2023.2236212.
- 10. Casara, B.G.S., Suitner, C., Jetten, J., The impact of economic inequality on conspiracy beliefs, Journal of Experimental Social Psychology, 2022, 98, 104245. doi: 10.1016/j.jesp.2021.104245.
- 11. McAdam, E., Hayashi, K., Barker, B., Hudson, R., JinCheol, C., Thomas, K., Kora, D., COVID-19 vaccination among young people who use drugs in Vancouver, Canada, Vaccine, 2024, 42, 864-870. doi: 10.1016/j.vaccine.2024.01.003.
- 12. Lambooij, M., Pijpers, J., van de Kassteele, J., et al., The effect of mobile vaccination units on vaccine uptake with COVID-19 vaccines: a within-neighbourhood analysis using national registration data, SSRN, Published online 2023. doi:10.2139/ssrn.4546773.
- 13. Derogatis, L.R., SCL-90-R: Administration, Scoring & Procedures Manual-II for the (Revised) Version and Other Instruments of the Psychopathology Rating Scale Series, Clinical Psychometric Research, 1992, 1-16.
- 14. Schmitz, N., Hartkamp, N., Kiuse, J., Franke, G.H., Reister, G., Tress, W., The Symptom Check-List-90-R (SCL-90-R): a German validation study, Quality of Life Research, 2000, 9, 185-193. doi:10.1023/a:1008931926181.
- 15. Arrindell, W.A., Ettema, J.H.M., SCL-90. Handleiding Bij Een Multidimensionele Psychopathologie-Indicator, Pearson, 2003.
- 16. Freeman, D., Loe, B.S., Chadwick, A., Vaccari, C., Waite, F., Rosebrock, L., et al., COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II, Psychological Medicine, 2022, 52, 3127-3141. doi:10.1017/S0033291720005188.
- 17. Küçük, E., Yeşilçiçek Çalık, K., Erkaya, R., Kanbay, Y., Oxford COVID-19 Aşısı Güven ve Uyum Ölçeği’nin Türk Kültürüne Uyarlanması ve Psikometrik Özelliklerinin İncelenmesi, KASHED, 2021, 7, 197-214.
- 18. Masson, C.L., McCuistian, C., Straus, E., Elahi, S., Chen, M., Gruber, V.A., et al., COVID-19 vaccine trust among clients in a sample of California residential substance use treatment programs, Drug and Alcohol Dependence, 2021, 225, 108812.
- 19. Hong C, Holloway IW, Bednarczyk R, Javanbakht M, Shoptaw S, Gorbach PM. High vaccine confidence is associated with COVID-19 vaccine uptake in gay, bisexual, and other men who have sex with men who use substances. LGBT Health. 2023;10:480-485.
- 20. Price O, Dietze PM, Maher L, et al. COVID-19 vaccine acceptability among people in Australia who inject drugs: update from the 2021 illicit drug reporting system interviews. Drug Alcohol Rev. 2022;41:1025-1028.
- 21. Vallecillo, G., Durán, X., Canosa, I., Roquer, A., Martinez, M.C., Perelló, R., COVID-19 vaccination coverage and vaccine hesitancy among people with opioid use disorder in Barcelona, Spain, Drug and Alcohol Review, 2022, 41, 1311-1318.
- 22. Aronson, I.D., Bennett, A.S., Ardouin-Guerrier, M.A., Rivera-Castellar, G., Gibson, B., Santoscoy, S., et al., How vaccine ambivalence can lead people who inject drugs to decline COVID-19 vaccination and ways this can be addressed: qualitative study, JMIR Formative Research, 2022, 6.
- 23. Gerretsen, P., Kim, J., Caravaggio, F., Quilty, L., Sanches, M., Wells, S., et al., Individual determinants of COVID-19 vaccine hesitancy, PLoS One, 2021, 16. doi: 10.1371/journal.pone.0250549.
- 24. Rolova, G., Gavurova, B., Petruzelka, B., Health literacy, self-perceived health, and substance use behavior among young people with alcohol and substance use disorders, International Journal of Environmental Research and Public Health, 2021, 18, 4337. doi:10.3390/ijerph18084337.
- 25. Berkman, N.D., Sheridan, S.L., Donahue, K.E., Halpern, D.J., Crotty, K., Low health literacy and health outcomes: an updated systematic review, Annals of Internal Medicine, 2011, 155, 97-107.
- 26. Paul, E., Steptoe, A., Fancourt, D., Attitudes towards vaccines and intention to vaccinate against COVID-19: implications for public health communications, Lancet Regional Health Europe, 2021, 1, 100012.
- 27. Nguyen, K.H., Huang, J., Mansfield, K., Corlin, L., Allen, J.D., COVID-19 vaccination coverage, behaviors, and intentions among adults with previous diagnosis, United States, Emerging Infectious Diseases, 2022, 28, 631-638. doi:10.3201/eid2803.211561.
- 28. Troiano, G., Nardi, A., Vaccine hesitancy in the era of COVID-19, Public Health, 2021, 194, 245-251.
- 29. Karimi, S.E., Amadi, S., Rampisheh, Z., et al., Predictors of COVID-19 vaccine uptake among people who use substances: a case study in Tehran, Substance Abuse Treatment, Prevention, and Policy, 2024, 19, 15. doi:10.1186/s13011-024-00596-9.
- 30. Tamargo, J.A., Martin, H.R., Diaz-Martinez, J., et al., Drug use and COVID-19 testing, vaccination, and infection among underserved, minority communities in Miami, Florida, PLoS One, 2024, 19.
- 31. Kafadar, A.H., Tekeli, G.G., Jones, K.A., et al., Determinants for COVID-19 vaccine hesitancy in the general population: a systematic review of reviews, Journal of Public Health (Berlin), 2023, 31, 1829-1845. doi:10.1007/s10389-022-01753-9
Türkiye'de Madde Kullanım Bozukluğu Olan Bireylerde COVID-19 Aşılanma Durumu ve Etkileyen Faktörler
Yıl 2025,
Cilt: 12 Sayı: 1, 178 - 185, 26.03.2025
Osman Hasan Tahsin Kılıç
,
Aykut Aydoğdu
,
Zehra Nur Bayram
,
Nida Üstün
,
Nazlı Deniz Munis
,
İlayda İncebıyık
,
Aysel Başer
Öz
Giriş ve Amaç: COVID-19 pandemisi, özellikle Madde Kullanım Bozukluğu (MKB) olan bireyler gibi sosyal açıdan dezavantajlı gruplar için önemli sosyoekonomik ve sağlık eşitsizliklerini belirgin hale getirmiştir. Bu popülasyonda ciddi COVID-19 geçirme riski artmış olmasına rağmen, MKB olan bireylerin genel nüfusa kıyasla daha fazla aşı tereddüdü yaşadığı ve daha düşük aşılama oranlarına sahip olduğu görülmüştür. Bu çalışma, Türkiye'deki MKB hastalarının aşılama durumunu değerlendirmeyi ve aşılanmayı etkileyen faktörleri araştırmayı amaçlamıştır.
Gereç ve Yöntemler: Bu tanımlayıcı kesitsel çalışma, MKB tanısı konmuş bireylerden oluşan bir örneklem içermekte olup, COVID-19 enfeksiyonu ve aşılanmaya ilişkin veriler dijital sağlık kayıtlarından alınmıştır. Sosyodemografik özellikler, paranoyak düşünceler ve aşı güveni yapılandırılmış formlar kullanılarak değerlendirilmiştir.
Bulgular:Aşıya olan güvenin aşılama durumunun birincil belirleyicisi olduğunu, diğer sosyodemografik faktörlerin ise aşılanma ile anlamlı bir ilişki göstermediğini ortaya koymaktadır.
Sonuç:Bu sonuçlar, sağlık hizmetlerine duyulan güvensizlik ve lojistik engelleri ele almak için özel olarak hazırlanmış halk sağlığı müdahalelerinin gerekliliğini vurgulamaktadır. Bu yüksek riskli grupta düşük aşılanma oranlarını daha iyi anlamak ve etkili önleme stratejileri geliştirmek için daha fazla araştırma yapılması önerilmektedir.
Kaynakça
- 1. Volkow, N.D., Blanco, C., Research on substance use disorders during the COVID-19 pandemic, Journal of Substance Abuse Treatment, 2021, 129, 108385. doi: 10.1016/j.jsat.2021.108385.
- 2. Mah, J.C., Penwarden, J.L., Pott, H., Theou, O., Andrew, M.K., Social vulnerability indices: a scoping review, BMC Public Health, 2023, 23, 1253. doi:10.1186/s12889-023-16097-6.
- 3. Wang, Q.Q., Kaelber, D.C., Xu, R., Volkow, N.D., COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States, Molecular Psychiatry, 2021, 26, 30-39.
- 4. Karavolis, Z., Thacker, E., Fabian, T., Douaihy, A., Reynolds, M., Kirisci, L., Tarter, R., Pharmacist-implemented intervention to surmount COVID-19 vaccination hesitancy in adults with substance use disorders, American Journal of Health-System Pharmacy, 2024, zxae095. doi:10.1093/ajhp/zxae095.
- 5. Cepeda, J.A., Feder, K.A., Astemborski, J., Schluth, C., Kirk, G.D., Mehta, S.H., Genberg, B.L., COVID-19 vaccine hesitancy and vaccination status in a community-based cohort of people who inject drugs in Baltimore, Maryland, March-June 2021, Public Health Reports, 2022, 137, 1031-1040. doi:10.1177/00333549221110299.
- 6. Andrade, G., COVID-19 vaccine hesitancy, conspiracist beliefs, paranoid ideation and perceived ethnic discrimination in a sample of university students in Venezuela, Vaccine, 2021, 39(47), 6837-6842. doi: 10.1016/j.vaccine.2021.10.037.
- 7. Swami, V., Weis, L., Lay, A., Barron, D., Furnham, A., Associations between belief in conspiracy theories and the maladaptive personality traits of the personality inventory for DSM-5, Psychiatry Research, 2016, 236, 86-90.
- 8. Matheson, S.L., Laurie, M., Laurens, K.R., Substance use and psychotic-like experiences in young people: a systematic review and meta-analysis, Psychological Medicine, 2023, 53, 305-319.
- 9. Ellilä, V., Levola, J., Denissoff, A., Partanen, M., Niemelä, S., Psychotic-like experiences and concurrent substance use among people who use new psychoactive substances, Substance Use & Misuse, 2023, 58, 1606-1614. doi:10.1080/10826084.2023.2236212.
- 10. Casara, B.G.S., Suitner, C., Jetten, J., The impact of economic inequality on conspiracy beliefs, Journal of Experimental Social Psychology, 2022, 98, 104245. doi: 10.1016/j.jesp.2021.104245.
- 11. McAdam, E., Hayashi, K., Barker, B., Hudson, R., JinCheol, C., Thomas, K., Kora, D., COVID-19 vaccination among young people who use drugs in Vancouver, Canada, Vaccine, 2024, 42, 864-870. doi: 10.1016/j.vaccine.2024.01.003.
- 12. Lambooij, M., Pijpers, J., van de Kassteele, J., et al., The effect of mobile vaccination units on vaccine uptake with COVID-19 vaccines: a within-neighbourhood analysis using national registration data, SSRN, Published online 2023. doi:10.2139/ssrn.4546773.
- 13. Derogatis, L.R., SCL-90-R: Administration, Scoring & Procedures Manual-II for the (Revised) Version and Other Instruments of the Psychopathology Rating Scale Series, Clinical Psychometric Research, 1992, 1-16.
- 14. Schmitz, N., Hartkamp, N., Kiuse, J., Franke, G.H., Reister, G., Tress, W., The Symptom Check-List-90-R (SCL-90-R): a German validation study, Quality of Life Research, 2000, 9, 185-193. doi:10.1023/a:1008931926181.
- 15. Arrindell, W.A., Ettema, J.H.M., SCL-90. Handleiding Bij Een Multidimensionele Psychopathologie-Indicator, Pearson, 2003.
- 16. Freeman, D., Loe, B.S., Chadwick, A., Vaccari, C., Waite, F., Rosebrock, L., et al., COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II, Psychological Medicine, 2022, 52, 3127-3141. doi:10.1017/S0033291720005188.
- 17. Küçük, E., Yeşilçiçek Çalık, K., Erkaya, R., Kanbay, Y., Oxford COVID-19 Aşısı Güven ve Uyum Ölçeği’nin Türk Kültürüne Uyarlanması ve Psikometrik Özelliklerinin İncelenmesi, KASHED, 2021, 7, 197-214.
- 18. Masson, C.L., McCuistian, C., Straus, E., Elahi, S., Chen, M., Gruber, V.A., et al., COVID-19 vaccine trust among clients in a sample of California residential substance use treatment programs, Drug and Alcohol Dependence, 2021, 225, 108812.
- 19. Hong C, Holloway IW, Bednarczyk R, Javanbakht M, Shoptaw S, Gorbach PM. High vaccine confidence is associated with COVID-19 vaccine uptake in gay, bisexual, and other men who have sex with men who use substances. LGBT Health. 2023;10:480-485.
- 20. Price O, Dietze PM, Maher L, et al. COVID-19 vaccine acceptability among people in Australia who inject drugs: update from the 2021 illicit drug reporting system interviews. Drug Alcohol Rev. 2022;41:1025-1028.
- 21. Vallecillo, G., Durán, X., Canosa, I., Roquer, A., Martinez, M.C., Perelló, R., COVID-19 vaccination coverage and vaccine hesitancy among people with opioid use disorder in Barcelona, Spain, Drug and Alcohol Review, 2022, 41, 1311-1318.
- 22. Aronson, I.D., Bennett, A.S., Ardouin-Guerrier, M.A., Rivera-Castellar, G., Gibson, B., Santoscoy, S., et al., How vaccine ambivalence can lead people who inject drugs to decline COVID-19 vaccination and ways this can be addressed: qualitative study, JMIR Formative Research, 2022, 6.
- 23. Gerretsen, P., Kim, J., Caravaggio, F., Quilty, L., Sanches, M., Wells, S., et al., Individual determinants of COVID-19 vaccine hesitancy, PLoS One, 2021, 16. doi: 10.1371/journal.pone.0250549.
- 24. Rolova, G., Gavurova, B., Petruzelka, B., Health literacy, self-perceived health, and substance use behavior among young people with alcohol and substance use disorders, International Journal of Environmental Research and Public Health, 2021, 18, 4337. doi:10.3390/ijerph18084337.
- 25. Berkman, N.D., Sheridan, S.L., Donahue, K.E., Halpern, D.J., Crotty, K., Low health literacy and health outcomes: an updated systematic review, Annals of Internal Medicine, 2011, 155, 97-107.
- 26. Paul, E., Steptoe, A., Fancourt, D., Attitudes towards vaccines and intention to vaccinate against COVID-19: implications for public health communications, Lancet Regional Health Europe, 2021, 1, 100012.
- 27. Nguyen, K.H., Huang, J., Mansfield, K., Corlin, L., Allen, J.D., COVID-19 vaccination coverage, behaviors, and intentions among adults with previous diagnosis, United States, Emerging Infectious Diseases, 2022, 28, 631-638. doi:10.3201/eid2803.211561.
- 28. Troiano, G., Nardi, A., Vaccine hesitancy in the era of COVID-19, Public Health, 2021, 194, 245-251.
- 29. Karimi, S.E., Amadi, S., Rampisheh, Z., et al., Predictors of COVID-19 vaccine uptake among people who use substances: a case study in Tehran, Substance Abuse Treatment, Prevention, and Policy, 2024, 19, 15. doi:10.1186/s13011-024-00596-9.
- 30. Tamargo, J.A., Martin, H.R., Diaz-Martinez, J., et al., Drug use and COVID-19 testing, vaccination, and infection among underserved, minority communities in Miami, Florida, PLoS One, 2024, 19.
- 31. Kafadar, A.H., Tekeli, G.G., Jones, K.A., et al., Determinants for COVID-19 vaccine hesitancy in the general population: a systematic review of reviews, Journal of Public Health (Berlin), 2023, 31, 1829-1845. doi:10.1007/s10389-022-01753-9