Education, trust, and likelihood to vaccinate against COVID-19 among patients with diabetes: Presenter(s): Christy Ledford, Medical College of Georgia at Augusta University, United States

BACKGROUND: Drawing on studies that demonstrate a relationship between education and vaccine hesitancy in the broader public, our purpose was to identify factors associated with likelihood to vaccinate among patients living with diabetes in the American South, a geographic region with high vaccine hesitancy located in the Diabetes Belt. METHODS: Following a retrospective chart review, we designed a survey to describe patients’ health behaviors in response to the COVID-19 pandemic. Measures included education, likelihood to get the COVID-19 vaccine, likelihood to get the COVID-19 vaccine after healthcare provider’s strong recommendation, and provider trust. As a surrogate measure of severity of diabetes, we recorded the A1c collected most closely prior to survey date. FINDINGS: Of 309 patients who met inclusion criteria, we successfully contacted 106 patients. 54 (50.9%) individuals completed the survey. An ANCOVA demonstrated the effect of education, controlling for age and A1c, onto likelihood to get the COVID vaccine. A paired t-test showed that patients reported a significant increase in likelihood to vaccinate after their providers’ strong recommendation. To better understand this influence, an ANCOVA tested the effect of education on likelihood to receive the vaccine after provider’s strong recommendation. Education was significantly associated with likelihood, but it was not a linear effect. Respondents who did not complete high school or graduated high school both increased in likelihood; however, individuals with some college did not. DISCUSSION: Severity of diabetes was not linked to vaccine acceptance. Clinicians cannot assume that patients with poorer glycemic control are more likely to vaccinate against COVID-19. Instead, clinicians should consider patient education when counseling patients. Patients who did not finish high school are receptive to healthcare providers’ strong recommendation. This group may experience the greatest benefit from vaccine education. Clinicians may need more time to counsel patients with some college education through vaccine hesitancy.