COVID-19 Vaccination Attitudes, COVID-19 Transmission, and Effects of the Pandemic on People Experiencing Homelessness

Context: People experiencing homelessness (PEH) experience poor health outcomes and face unique barriers to medical care, including vaccination. Thus, this vulnerable population necessitates specific consideration during the COVID-19 pandemic.

Objective: This project sought to assess impact of the COVID pandemic, factors contributing to COVID transmission, and reasons for COVID vaccination among PEH.

Study Design and Analysis: Fifty-six surveys were collected. Frequencies were calculated for all questions and Chi square analyses were performed.

Setting: Resource center for PEH in Charleston, SC.

Population studied: Participants had an average age of 44.9 years, of which 44.6% identified as female and 55.4% as male, 48.2% identified as Black and 41.1% as White.

Instrument: Paper surveys with free response, mark all that apply, and multiple-choice questions.

Outcome Measures: Changes in food insecurity and housing status with the pandemic, ability to follow COVID transmission mitigation recommendations and access testing, and reasons for or against vaccination.

Results: During the pandemic, 26.8% experienced housing relocation, of which 50.0% lost permanent housing. Food access was noted as worse than before the pandemic by 28.6% of people. 76.8% of respondents had been tested for COVID, of which 34.4% had tested positive. 92.8% of people felt they could socially distance. 98.2% and 87.5% of respondents felt they could access a mask or hand-sanitizer, respectively. Some common reasons for vaccination were to protect themselves (75.6%) or others (41.5%). The most common reasons given to not be vaccinated were being unsure it would work (40.0%) and believing it has not been tested enough (40.0%). There were no significant associations between the respondents having been COVID vaccinated and their race (p=.761), gender (p= .137), or age group (p= .767). There were significant associations between whether a respondent has been COVID vaccinated and if they work closely with others (p=.006) or if they were an essential worker (p=.002).

Conclusion: Our findings suggests that the pandemic negatively impacted food and housing security for PEH in Charleston, SC. Access to testing and transmission mitigation resources was high. Vaccination status and employment setting were associated. Unvaccinated PEH indicated similar reasons to not get vaccinated as the general US population.