(P-PH-1) Adherence to COVID-19 vaccination and vaccine hesitancy in US blood donors

Adherence to vaccination recommendations has been decreasing despite unequivocal public health benefits. Noncompliance can result from access barriers and/or hesitant attitudes. Incomplete vaccination could increase the vulnerability of blood donors to preventable infections, compromising their ability to contribute with the blood supply. Scarce studies have investigated the prevalence and determinants of noncompliance with COVID-19 vaccination recommendations in blood donors.

Study

Design/Methods:

In this cross-sectional study, we enrolled blood donors who responded to a survey including comorbidities and health rating, COVID-19 infection and vaccination history, and barriers/motivations associated with COVID-19 vaccination. Deidentified demographics were extracted from donation databases. We estimate the prevalence of noncompliance, the prevalence of hesitancy towards COVID-19 vaccines, and investigate associated factors using multivariable models.
The protocol for the COVID-19 survey was reviewed and approved by an independent review board (Advarra protocol Pro00056783); all survey participants provided informed consent prior to inclusion.

 

Results/Findings:

From December 2021 to April 2023, 33,610 donors were included; 7,944 (24%; 95% CI 23-24%) had not been vaccinated for COVID-19 or had missing vaccination information and were categorized as noncompliant with COVID-19 vaccination recommendations. Of those, 40% (95% CI 39-41%) reported at least 1 of 3 hesitant attitudes displayed in the survey (safety concerns; personal/cultural/religious beliefs; being young and not worrying about being vaccinated). Only 1% of the noncompliant donors reported access barriers. In the multivariable models, younger age, male gender, White/Caucasian race, absence of comorbidities, residency in a State with low-level COVID-19 policies, and living in micropolitan or rural areas were associated with vaccine noncompliance; younger age and White/Caucasian race were associated with vaccine hesitancy among noncompliant donors (Table 1).

Conclusions:

We found high rates of noncompliance with COVID-19 vaccination recommendations in blood donors, often driven by vaccine hesitancy. Understanding vaccine adherence among blood donors – a relatively highly educated and healthy population, with good healthcare access and usually motivated by altruism - could provide key information on determinants of vaccine noncompliance that may be harder to overcome.