Journal Article

Using the diffusion of innovations theory to understand factors associated with COVID-19 vaccination among tobacco users

Yingst, Jessica M., D’Souza, Gail Carmen, Calo, William A., Krebs, Nicolle M., Hobkirk, Andrea L., Foulds, Jonathan, Allen, Sophia I., Bordner, Candace

2024

Overview

The coronavirus disease (COVID-19) pandemic has spread in the US with more than 100 million human infections and a million deaths since March 2020. A population of concern are high-risk individuals such as adults who are tobacco users, since COVID-19 is a respiratory disease that affects the lungs. Although 79% of the US population ≥ 18 years of age have completed the primary COVID-19 vaccine series; it is imperative to understand the factors associated with receiving or declining the COVID-19 vaccine among high-risk populations to improve vaccination rates. Guided by the diffusion of innovations (DOI) theory, this study identified factors associated with COVID-19 vaccination and the impact on COVID-19 vaccine uptake in adults who use tobacco. We conducted a cross-sectional study using a sample of Pennsylvanian adult tobacco users by sending a unique survey link to 4,081 email addresses in April 2022. Participants were asked about tobacco use, COVID-19 vaccination status, and reasons for receiving/declining the COVID-19 vaccine. Participants (n = 157) were 75% female, 96% White, 74% current tobacco users, and had a mean age of 50.1 (SD = 10.8) years. Nearly 78% (n = 119) received at least one dose of the COVID-19 vaccine (primary series). We categorized all vaccinated tobacco users into adopter categories of the DOI theory; innovators (10%), early adopters (14%), early majority (33%), late majority (11%), and laggards (32%). The major reason that prompted participants to get the COVID-19 vaccine was to ensure they were well protected against COVID-19 infection (77%). Additionally, the only reason for receiving the vaccine that significantly predicted early vaccine uptake (being an innovator or early adopter) was “to loosen restrictions on mask mandates and social/physical distancing” (p = 0.0180). Among the 22% that did not receive a COVID-19 vaccine, the most common major reason they declined the vaccine was because they felt politics played a big role in the vaccine development process (94%). Our findings suggest that major f actors that influenced why adult tobacco users would receive or decline the COVID-19 vaccine included infection control mandates, protection from the COVID-19 infection, and politics. Investigating these factors can help public health professionals design or develop future vaccination programs for high-risk populations in order to scale up vaccination rates.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Adults / Age / Biology and Life Sciences / Care and treatment / Chronic obstructive pulmonary disease / Coronaviruses / COVID-19 / COVID-19 - epidemiology / COVID-19 - prevention & control / COVID-19 vaccines / COVID-19 Vaccines - administration & dosage / Cross-Sectional Studies / Design factors / Diagnosis / Diffusion of Innovation / Diffusion rate / Drug dosages / Electronic cigarettes / FDA approval / Female / Health aspects / Humans / Innovations / Lung diseases / Male / Medical personnel / Medicine and Health Sciences / Middle Aged / Pandemics / Politics / Population decline / Populations / Public health / Respiratory diseases / Respiratory tract diseases / Risk / Risk factors / SARS-CoV-2 - immunology / Smoking / Social Sciences / Surveys and Questionnaires / Tobacco / Tobacco Use - epidemiology / Vaccination / Vaccine development / Vaccines