Exploring the Role of Vaccine Confidence in COVID-19 Vaccination Among a Community-Based Sample of Women Who Use Drugs in Baltimore, Maryland

Prevalence of COVID-19 vaccination among women who use drugs is largely unknown. Using a community-based sample, we explored correlates of COVID-19 vaccination stratified by level of vaccine confidence, measured by the widely used Vaccine Hesitancy Scale. Level of vaccine confidence was found to be significantly associated with uptake of the COVID-19 vaccine as well as recent flu vaccination. Poisson regression with robust variance was used to identify correlates of vaccination within both groups. Among higher-confidence women, vaccine uptake was associated with education and experiencing pandemic-related health care barriers and food insecurity, and likelihood of vaccination was lower among those who did not believe the vaccine was FDA-approved than among those who did. Among lower-confidence women, likelihood of vaccination was greater among Black women, those in shared housing, and drug treatment, but lower among those recruited from high-vaccination neighborhoods and who believed newer vaccines carry greater risk.