COVID-19 Vaccine Acceptance in Rheumatology Patients in the United States

Background: The American College of Rheumatology (ACR) recommends COVID-19 vaccination for all patients with rheumatic disease (RMD). However, there is limited data on COVID-19 vaccine acceptance and reasons for hesitancy among RMD patients. This study assessed the basis for COVID-19 vaccine hesitancy in rheumatology patients seen at a large academic medical center in the Southeastern United States.Methods: An electronic survey was distributed to institutional RMD patients January 2021. Questions elicited demographic characteristics, COVID-19 vaccination intention, and attitudes regarding the COVID-19 vaccine. Descriptive statistics and multiple linear regression analysis were used to evaluate factors associated with vaccine hesitancy. Principal factor analysis and Cronbach’s alpha coefficient were used to assess the psychometric properties of the survey.Findings: A total of 432 patients responded to the survey, of whom 83% were female, 10% of Black race, and 50% affiliated with the Democratic party. Eighty-five percent desired immediate vaccination against COVID-19. Backward regression models identified White race (OR: 4.43; 95% CI: 1.80, 10.98) and affiliation with the Democratic party (OR: 4.20; 95% CI: 1.93, 9.20) as independent predictors of wanting the vaccine. Conversely, among patients not ready to get the vaccine, 34% cited safety concerns related to their rheumatologic diagnosis as the primary cause for hesitation; 45% of patients indicated they would be more likely to get vaccinated if encouraged by a trusted physician.Interpretation: The majority of rheumatology patients desired COVID-19 vaccination, with White race and Democratic party affiliation being strongly associated with vaccine acceptance. Among hesitant patients, many are seeking recommendations from a trusted physician, supporting the idea that rheumatologists play a role in protecting RMD patients from COVID-19 by encouraging immunization.Funding Information: Duke University School of Medicine.Declaration of Interests: RES: None to declare AME: Receives research funding from NIH NCATS Award Number 1KL2TR002554 LV: Receives research funding from NIH NCATS Award Number 1KL2TR002554 KRJ: Receives research funding from the U.S. Department of Education Javits Grant Award Number S206A200007-21 JLR: None to declare KS: Receives research funding from NIH NCATS Award Number 1KL2TR002554 LCS: None to declare MM: None to declare JD: None to declare MEBC: None to declare.INCOMPLETE (MISSING VLL)Ethics Approval Statement: The study was approved by the Duke University Hospital System Institutional Review Board: Pro00105946.