Factors Associated with COVID-19 Vaccine Perception in SLE Patients from the Georgians Organized Against Lupus Cohort
| Category | Sub-Category | Overall (n=598) | COVID-19 Vaccination Perception | |||
|---|---|---|---|---|---|---|
| Receptive (n=342) | Hesitant (n=252) | P-Value | ||||
| Socio- demographics | Age at Survey Completion (year) | 18-34 | 85 (14.2) | 30 (8.8) | 55 (21.8) | <0.0001 |
| 34-54 | 264 (44.1) | 132 (38.6) | 131 (52.0) | |||
| 55+ | 249 (41.6) | 180 (52.6) | 66 (26.2) | |||
| Gender | male | 40 (6.7) | 24 (7.0) | 15 (6.0) | 0.6 | |
| female | 558 (93.3) | 318 (93.0) | 237 (94.0) | |||
| Race | Non-Black | 129 (21.6) | 105 (30.7) | 23 (9.1) | <0.0001 | |
| Black | 469 (78.4) | 237 (69.3) | 229 (90.9) | |||
| Marital Status | Never married | 203 (34.0) | 95 (27.8) | 107 (42.6) | 0.0001 | |
| Married | 201 (33.7) | 140 (40.9) | 59 (23.5) | |||
| Separated | 24 (4.0) | 14 (4.1) | 9 (3.6) | |||
| Divorced | 104 (17.4) | 57 (16.7) | 47 (18.7) | |||
| Widowed | 22 (3.7) | 15 (4.4) | 7 (2.8) | |||
| Living with Partner | 43 (7.2) | 21 (6.1) | 22 (8.8) | |||
| Living in Poverty | Yes | 147 (25.5) | 52 (15.8) | 94 (38.5) | <0.0001 | |
| Current Work Status | Employed | 248 (42.8) | 150 (45.6) | 97 (39.4) | <0.0001 | |
| Off work force | 125 (21.6) | 92 (28.0) | 31 (12.6) | |||
| Unemployed | 206 (35.6) | 87 (26.4) | 118 (48.0) | |||
| Educational Attainment | ≤ High School | 159 (27.0) | 73 (21.7) | 85 (34.3) | <0.0001 | |
| Some College | 186 (31.6) | 97 (28.8) | 87 (35.1) | |||
| ≥ College | 243 (41.3) | 167 (49.6) | 76 (30.6) | |||
| Insurance type | Medicare and/or Medicaid | 307 (51.6) | 160 (46.9) | 144 (57.6) | <0.0001 | |
| Private | 233 (39.2) | 166 (48.7) | 66 (26.4) | |||
| Under or uninsured | 55 (9.2) | 15 (4.4) | 40 (16.0) | |||
| Health Care Provider | Primary Care Physician visit in past 12 months | Yes | 505 (84.4) | 298 (87.1) | 203 (80.6) | 0.03 |
| Rheumatologist visit in past 12 months | Yes | 516 (86.3) | 294 (86.0) | 220 (87.3) | 0.6 | |
| Lupus Characteristics | Disease Duration (year) | Mean ± SD | 18.7 ± 10.4 | 20.4 ± 10.4 | 16.2 ± 9.7 | <0.0001 |
| Age at Lupus Diagnosis (year) | Mean ± SD | 32.7 ± 11.9 | 34.4 ± 12.3 | 30.3 ± 11.1 | <0.0001 | |
| Disease Activity: Systemic Lupus Activity Questionnaire (SLAQ) score | Mean ± SD | 12.6 ± 8.2 | 12.2 ± 7.7 | 13.3 ± 8.8 | 0.1 | |
| Organ Damage: Self-Administered Brief Index Damage (BILD) score | Mean ± SD | 3.3 ± 3.0 | 3.4 ± 3.2 | 3.2 ± 2.6 | 0.4 | |
| Organ Damage Group | No Damage (BILD=0) | 73 (12.2) | 41 (12.0) | 32 (12.7) | 0.9 | |
| Mild damage (BILD=1 or 2) | 199 (33.3) | 116 (33.9) | 82 (32.5) | |||
| Severe damage (BILD≥3) | 326 (54.5) | 185 (54.1) | 138 (54.8) | |||
| Medications - current | glucocorticoids | 247 (42.3) | 127 (38.1) | 120 (48.4) | 0.01 | |
| methotrexate | 35 (6.2) | 16 (4.9) | 19 (7.9) | 0.1 | ||
| cyclosporine | 1 (0.2) | 1 (0.3) | 0.4 | |||
| dapsone | 8 (1.4) | 4 (1.2) | 4 (1.7) | 0.7 | ||
| belimumab | 29 (5.1) | 17 (5.2) | 11 (4.5) | 0.7 | ||
| anti-TNF agents | 9 (1.6) | 5 (1.5) | 4 (1.6) | 0.9 | ||
| hydroxychloroquine | 415 (70.6) | 236 (70.4) | 177 (70.8) | 0.9 | ||
| cyclophosphamide | 11 (1.9) | 7 (2.2) | 4 (1.7) | 0.8 | ||
| mycophenolate mofetil | 116 (20.2) | 59 (18.1) | 57 (23.4) | 0.1 | ||
| azathioprine | 73 (12.7) | 35 (10.7) | 38 (15.7) | 0.1 | ||
| rituximab | 13 (2.3) | 4 (1.2) | 9 (3.7) | 0.1 | ||
| Highest Steroid Dose in the past 12 months (mg/day) | Mean ± SD | 18.7 ± 21.8 | 17.2 ± 22.5 | 20.3 ± 21.2 | 0.3 | |
| Sources of trusted COVID-19 information | Government | 298 (49.8) | 202 (59.1) | 94 (37.3) | <0.0001 | |
| News | 289 (48.3) | 182 (53.2) | 103 (40.9) | 0.003 | ||
| Social Media | 44 (7.4) | 24 (7.0) | 20 (7.9) | 0.7 | ||
| Doctors | 445 (74.4) | 276 (80.7) | 165 (65.5) | <0.0001 | ||
| Lupus Advocacy or Support Groups | 333 (55.7) | 203 (59.4) | 128 (50.8) | 0.04 | ||
| COVID-19 Well-Being | Concern for COVID-19 in general | Not at all concerned | 9 (1.5) | 2 (0.6) | 7 (2.8) | 0.049 |
| A little concerned | 34 (5.7) | 14 (4.1) | 20 (8.0) | |||
| Moderately concerned | 77 (13.0) | 42 (12.4) | 34 (13.6) | |||
| Very concerned | 200 (33.7) | 119 (35.0) | 79 (31.6) | |||
| Extremely concerned | 274 (46.1) | 163 (47.9) | 110 (44.0) | |||
| Concern lupus will worsen | 0 (not concerned) | 63 (10.8) | 39 (11.6) | 22 (9.1) | 0.5 | |
| 1 | 21 (3.6) | 15 (4.5) | 6 (2.5) | |||
| 2 | 18 (3.1) | 11 (3.3) | 7 (2.9) | |||
| 3 | 22 (3.8) | 12 (3.6) | 10 (4.1) | |||
| 4 | 10 (1.7) | 6 (1.8) | 3 (1.2) | |||
| 5 | 57 (9.8) | 24 (7.1) | 32 (13.2) | |||
| 6 | 35 (6.0) | 19 (5.6) | 16 (6.6) | |||
| 7 | 40 (6.8) | 24 (7.1) | 16 (6.6) | |||
| 8 | 63 (10.8) | 41 (12.2) | 22 (9.1) | |||
| 9 | 46 (7.9) | 27 (8.0) | 19 (7.8) | |||
| 10 (extremely concerned) | 209 (35.8) | 119 (35.3) | 90 (37.0) | |||
| Concern for getting infected with COVID-19 | 0 (not concerned) | 43 (7.4) | 22 (6.5) | 20 (8.3) | 0.4 | |
| 1 | 15 (2.6) | 6 (1.8) | 9 (3.8) | |||
| 2 | 24 (4.1) | 15 (4.5) | 9 (3.8) | |||
| 3 | 18 (3.1) | 10 (3.0) | 7 (2.9) | |||
| 4 | 17 (2.9) | 9 (2.7) | 8 (3.3) | |||
| 5 | 69 (11.9) | 32 (9.5) | 37 (15.4) | |||
| 6 | 30 (5.2) | 20 (5.9) | 9 (3.8) | |||
| 7 | 39 (6.7) | 25 (7.4) | 14 (5.8) | |||
| 8 | 62 (10.7) | 41 (12.2) | 21 (8.8) | |||
| 9 | 54 (9.3) | 31 (9.2) | 23 (9.6) | |||
| 10 (extremely concerned) | 209 (36.0) | 126 (37.4) | 83 (34.6) | |||
| Concern for someone in family getting infected | 0 (not concerned) | 37 (6.4) | 20 (6.0) | 16 (6.6) | 0.2 | |
| 1 | 14 (2.4) | 6 (1.8) | 8 (3.3) | |||
| 2 | 13 (2.2) | 5 (1.5) | 8 (3.3) | |||
| 3 | 10 (1.7) | 5 (1.5) | 5 (2.1) | |||
| 4 | 12 (2.1) | 8 (2.4) | 4 (1.7) | |||
| 5 | 61 (10.5) | 28 (8.4) | 33 (13.6) | |||
| 6 | 24 (4.1) | 14 (4.2) | 10 (4.1) | |||
| 7 | 30 (5.2) | 17 (5.1) | 12 (5.0) | |||
| 8 | 63 (10.9) | 44 (13.2) | 19 (7.9) | |||
| 9 | 61 (10.5) | 41 (12.3) | 20 (8.3) | |||
| 10 (extremely concerned) | 254 (43.9) | 146 (43.7) | 107 (44.2) | |||
| Vaccination Attitudes Examination (VAX ) scale | Mistrust (do not feel safe, cannot rely to stop serious infection, do not feel protected) | Mean ± SD | 3.2 ± 1.6 | 2.4 ± 1.2 | 4.2 ± 1.5 | <0.0001 |
| Unseen Effect (problems yet to be discovered, unforeseen problems in children, worry about unknown future effects) | Mean ± SD | 4.1 ± 1.3 | 3.9 ± 1.2 | 4.4 ± 1.4 | <0.0001 | |
| Profiteering (Pharma profits, authorities profit, vaccination programs are a big con) | Mean ± SD | 2.8 ± 1.5 | 2.4 ± 1.3 | 3.4 ± 1.4 | <0.0001 | |
| Natural Immunity (natural immunity lasts longer, natural exposure gives safest protection, natural exposure is safer) | Mean ± SD | 2.6 ± 1.3 | 2.3 ± 1.2 | 3.0 ± 1.3 | <0.0001 | |
| VAX score | Mean ± SD | 3.2 ± 1.0 | 2.8 ± 0.9 | 3.8 ± 0.9 | <0.0001 | |
| Vaccine Beliefs | People with lupus have more vaccine side effects | Strongly disagree | 37 (6.3) | 30 (8.8) | 6 (2.4) | <0.0001 |
| Disagree | 81 (13.7) | 67 (19.7) | 12 (4.8) | |||
| Neither agree nor disagree | 367 (62.0) | 209 (61.5) | 157 (63.3) | |||
| Agree | 73 (12.3) | 26 (7.6) | 47 (19.0) | |||
| Strongly agree | 34 (5.7) | 8 (2.4) | 26 (10.5) | |||
| Vaccine will flare lupus | Strongly disagree | 48 (8.1) | 41 (12.1) | 6 (2.4) | <0.0001 | |
| Disagree | 83 (14.0) | 71 (20.9) | 10 (4.0) | |||
| Neither agree nor disagree | 382 (64.5) | 209 (61.5) | 172 (69.4) | |||
| Agree | 54 (9.1) | 12 (3.5) | 42 (16.9) | |||
| Strongly agree | 25 (4.2) | 7 (2.1) | 18 (7.3) | |||
| Vaccine is not as effective in lupus | Strongly disagree | 71 (12.0) | 56 (16.6) | 13 (5.2) | <0.0001 | |
| Disagree | 117 (19.8) | 90 (26.6) | 26 (10.5) | |||
| Neither agree nor disagree | 347 (58.8) | 169 (50.0) | 177 (71.4) | |||
| Agree | 39 (6.6) | 18 (5.3) | 21 (8.5) | |||
| Strongly agree | 16 (2.7) | 5 (1.5) | 11 (4.4) | |||
| Vaccination Behavior | Number of flu shots in the past 3 seasons | 0 | 118 (19.9) | 33 (9.7) | 85 (33.9) | <0.0001 |
| 1 | 86 (14.5) | 41 (12.0) | 45 (17.9) | |||
| 2 | 71 (12.0) | 39 (11.4) | 32 (12.7) | |||
| 3 | 319 (53.7) | 228 (66.9) | 89 (35.5) | |||
| Psychosocial | Perceived Stress | Mean ± SD | 15.8 ± 7.0 | 15.6 ± 7.1 | 16.1 ± 6.9 | 0.4 |
| Healthcare Discrimination: Better care if different race/ethnic group | Yes | 86 (20.1) | 53 (20.2) | 33 (20.0) | 0.9 | |
| PROMIS Self-efficacy: manage medication and treatment (T-score) | Mean ± SD | 49.2 ± 9.4 | 49.7 ± 9.2 | 48.5 ± 9.6 | 0.1 | |
| Brief Resilience Scale | Mean ± SD | 3.6 ± 0.8 | 3.7 ± 0.8 | 3.5 ± 0.8 | 0.02 | |
| PROMIS Depression (T-Score) | Mean ± SD | 49.3 ± 9.3 | 48.3 ± 8.7 | 50.5 ± 10.0 | 0.004 | |
| Everyday Discrimination | Mean ± SD | 1.4 ± 0.6 | 1.4 ± 0.6 | 1.5 ± 0.6 | 0.2 | |
PROMIS=Patient-Reported Outcomes Measurement Information System