Despite being disproportionately affected by the COVID-19 pandemic, people who inject drugs (PWID) have markedly lower and more variable rates of COVID-19 vaccine uptake—ranging from 10% to 81%—compared to 79% of all US adults. Multiple implementation adaptations have been proposed to address this gap, including offering the vaccines at syringe service programs (SSPs). To inform their implementation at an SSP in Miami, Florida, this study aimed to identify predictors of COVID-19 vaccine uptake and preferences for service delivery among PWID in our context. Between June 2022 and July 2023, we administered a cross-sectional survey based on the Health Belief Model with PWID accessing services at an SSP in Miami, FL (n = 135). Bivariate analysis was used to identify factors associated with COVID-19 vaccination status (vaccinated vs. not vaccinated). Only 65% of participants had received at least one dose of the COVID-19 vaccine series. Factors associated with COVID-19 vaccination included older age (42 vs. 38 years, p = 0.0287), requiring medical care for previous COVID-19 infections (p = 0.0173), being confident in the US healthcare system (p = 0.0023), and not believing multiple COVID-19 misconceptions (p < 0.05). Among the Health Belief Model domains, perceived benefit, self-efficacy, and one cue to action item were significantly associated with COVID-19 vaccination status: vaccinated participants were more likely to believe in the vaccines’ benefits (p = 0.0045–0.0213), report it was easy to get vaccinated (p = 0.0159), and know where to obtain accurate vaccine information (p = 0.0477). Most participants (86%) preferred to receive the COVID-19 vaccine at the SSP, and suggestions for increasing uptake included offering compensation, utilizing peer outreach systems, providing information and reminders, and allowing for accelerated vaccination schedules. Our findings reiterate the potential of SSPs to increase COVID-19 and other vaccination rates among PWID and provide insight into implementation adaptations to optimize vaccine uptake, including emphasizing the benefit of vaccines in communication efforts, offering compensation, and leveraging the trusted relationship with SSP staff, particularly peer navigators. Together, this evidence reinforces SSPs’ unique ability to increase engagement with and utilization of preventative care services among PWID, within and beyond the COVID-19 pandemic.
Plesons et al. (Sun,) studied this question.