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Public Health Watch: CDC Analysis Highlights Vaccine Challenges for People with Disabilities

Lower rates of COVID-19 vaccination may be due to access, not hesitancy.

COVID-19 vaccine hesitancy remains a hot-button issue in the United States, even with two-thirds of the eligible population fully inoculated against the virus, according to the Centers for Disease Control and Prevention (CDC).

Although recent weeks have seen an uptick in vaccine uptake, due in large part to controversial vaccine mandates on the part of governments and employers, a significant segment of the population is still not inoculated. Solving the issue will likely be as complex as the reason behind some people’s vaccine hesitancy, experts say.

For example, people living with disabilities are hardly a group that comes to mind when one considers the “anti-vaxxer” movement. However, an analysis published on October 1 by the CDC’s Morbidity and Mortality Weekly report found that adults with a disability were 12% less likely than those without a disability to report having received at least 1 dose of a COVID-19 vaccine—an issue of access, rather than hesitancy, perhaps.

“The data from this study suggest that people with disabilities do not have the same level of access to COVID-19 vaccination as do people without disabilities,” coauthor Blythe Ryerson, PhD, associate director for Science, Division of Human Development and Disability at the CDC’s National Center on Birth Defects and Developmental Disabilities, told Contagion. “This disparity can likely be mitigated by addressing the barriers noted by the study participants, including easier access to vaccination information and scheduling services, and more accessible vaccination sites or offerings of in-home vaccination services.”

Indeed, adults living with disabilities in the study were nearly twice as likely to indicate that they planned to get vaccinated and 29% more likely to “report higher endorsement of vaccine as protection” than those who did not have a disability, according to Ryerson and her colleagues. However, they were also more likely to report that it would be or was difficult to get vaccinated than did adults without a disability (age-adjusted prevalence ratio: 2.69).

The findings are based on a telephone survey of 56,749 unvaccinated adults in the United States, 5361 (9.4%) of whom reported having a disability. Among unvaccinated adults, those with a disability were 61% more likely than those without one to report they were very or moderately concerned about getting COVID-19. Still, they were also more than twice as likely to indicate they were having difficulty getting an appointment online and nearly twice as likely to say that they did not know where to get vaccinated. Perhaps not surprisingly, they were nearly 4 times as likely to report that they had concerns about being able to get to a vaccination site and 69% more likely to suggest that sites were not open at convenient times.

“The results from this study indicate that improved education and access for people with disabilities are critical but there is likely much more that can be done,” Ryerson said. “The results also indicate that access may be the greatest barrier. Public health and immunization providers can establish or improve existing partnerships with community organizations, leaders, other local partners, and people with disabilities to identify specific barriers and assist in the development and implementation of strategies to improve access and reduce hesitancy. For example, is vaccination information and access open to people who have vision, hearing, mobility, understanding, or other support needs? Engaging people with disabilities and lived experiences is essential for any effective public health preparedness and response initiative.”

These people are, after all, among the most vulnerable to severe illness from COVID-19.