(PS5-B48) Development of a COVID-19 Vaccine Hesitancy Single Session Group Intervention for US Veterans

Introduction: Rates of COVID-19 vaccine hesitancy were high during the time of vaccine rollout, with a higher percentage in specific racial and political subgroups. Given that our Veterans Affairs Medical Center resides in the Bronx, one of the most ethnically diverse areas in the US yet ranked last of New York State’s 62 counties for health, we sought to directly confront COVID-19 vaccine hesitancy in this population. This quality assurance and improvement project aimed to 1) identify factors underlying vaccine hesitancy in a racially diverse, Veteran population through telephone outreach calls to develop a Vaccine Hesitancy Single Session Group Intervention (SSGI) at the Bronx VA that addresses these concerns and improve vaccination rates; 2) conduct the SSGI, and use exploratory analyses to preliminarily assess effectiveness of SSGI in increasing receipt of the COVID-19 vaccine.

Method: Vaccine hesitancy was identified in 690 Veterans at the Bronx VA. Our research team conducted outreach calls to these Veterans, successfully reaching 137 of them to recruit for our SSGI. We developed the SSGI to be manualized and integrate elements of motivational interviewing, psychoeducation and peer support to promote dialogue and decision-making tools pertaining to COVID-19 vaccines. It balances skill instruction with opportunities for Veterans to share concerns and exchange information. There were two group facilitators from MH services, a Preventative Medicine resident, a “vaccine positive” Veteran peer, as well as a communication coordinator. Veterans were sent a Qualtrics survey pre and post group to assess hesitancy. Data collection was completed from February-April 2021. All procedures were completed remotely via phone, Qualtrics, and WebEx. Vaccination status and MH diagnosis were determined by chart review.

Results: Thirty Veterans attended the SSGI over 8 groups, averaging 3.5 participants per session. Demographics such as age, gender, race, ethnicity, religion, and mental health status will be presented at time of conference. Statistics on vaccine turnout post group as well as shift in hesitancy ratings will also be presented. From the groups, themes for hesitancy were identified, including: 1) concerns that the vaccine was developed too quickly, 2) the need for long-term safety data, 3) concerns about immediate side effects following injection, 4) fears of DNA modification, and 5) questions regarding vaccine ingredients.

Conclusions: The SSGI highlights the potential impact of a group-based, peer encounter to address vaccine hesitancy. Lessons learned will be presented, such as the success of active listening over a didactic approach as well as the benefit of incorporating “pro-vaccine” peers in the group. Additionally, adopting psychological approaches and using MH providers may be particularly useful in addressing vaccine hesitancy. While vaccination rates increased from the program, a significant number of Veterans remain hesitant or refusing of the vaccine. Next steps may require incentives or the passage of time with limited adverse outcomes in those who are vaccinated.