Future pandemic preparedness: conceptualizing vaccine willingness in drug-using populations during COVID-19 in Southeastern U.S. Cities

The COVID-19 pandemic exacerbated health challenges among people who use opioids (PWUO) and substance using men who have sex with men (SU-MSM) in Southeastern United States cities. Within the larger NIDA Clinical Trials Network Protocol 0082 PrEP attitudes and opioid use services implementation survey, N = 171 PWUO and N = 169 SU-MSM answered a COVID-19 vaccine attitudes survey, including measures of vaccine willingness and health beliefs. In mixed-effects linear models for PWUO and SU-MSM, respectively: (1) belief in vaccine protection from illness was positively correlated with vaccine willingness; and (2) sense of being “a guinea pig” was negatively correlated with vaccine willingness. Having previously used a COVID-19 antigen test was positively correlated with vaccine willingness in SU-MSM. This study aims to define vaccine willingness during the COVID-19 pandemic among people who use drugs and proposes the use of the Health Belief Model to conceptualize the correlation between health beliefs and intended behaviors.