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Factors Associated with COVID-19 Vaccination Uptake in Great Plains American Indian Communities

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Abstract

With the development of the COVID-19 vaccine in late 2020, the importance of understanding the drivers of vaccine acceptance and vaccine hesitancy is important for the health of American Indian and Alaska Native communities. We conducted a cross-sectional, anonymous survey in October 2021 using established quantitative methods of virtual surveys to reach tribal members living on three reservations in the Great Plains (N = 679). We conducted multivariate analyses using logistic regression to assess the association between independent variables and COVID-19 vaccination status after adjusting for confounding. Respondents were more likely to have received a COVID-19 vaccine if they were older, had a full-time job, had previously received a flu vaccination, reported a higher level of trust in the health care system, had increased access to vaccinations, were able to isolate, or if they held a desire to keep their family safe. This study is one of the first to offer insights into the associations and possible determinants of COVID-19 vaccine uptake among American Indians in the Great Plains and was completed as part of the National Institutes of Health Rapid Acceleration of Diagnostics of Underserved Populations consortium. We identified a set of demographic, socioeconomic, and motivational factors that are associated with COVID-19 vaccination uptake among Great Plains American Indians and Alaska Natives. It is possible that future vaccine uptake may be enhanced through economic development, strengthening health care operations and care quality, and focusing vaccination messaging on family and community impact.

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Data Availability

The study data is not available according to established Tribal sovereignty practices.

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Funding

Research reported in this RADx® Underserved Populations (RADx-UP) publication was supported by the National Institutes of Health under Award Number 5R01CA240080-03S1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA

    Sara J. Purvis & Matthew Tobey

  2. Columbia Irving Medical Center, New York City, NY, USA

    Katrina Armstrong

  3. College of Nursing South Dakota State University, Rapid City, SD, USA

    Mary J. Isaacson

  4. Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Alexander Soltoff

  5. Great Plains Tribal Epidemiology Center, Great Plains Tribal Leaders’ Health Board, Rapid City, SD, USA

    Tinka Duran

  6. Community Health Prevention Programs, Great Plains Tribal Leaders’ Health Board, Rapid City, SD, USA

    Gina Johnson

  7. American Indian Health Initiative, Avera Health, Sioux Falls, SD, USA

    J.R. LaPlante

  8. Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA, USA

    Bethany-Rose Daubman

Authors
  1. Sara J. Purvis
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  2. Katrina Armstrong
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  3. Mary J. Isaacson
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  4. Alexander Soltoff
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  9. Matthew Tobey
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Contributions

All authors contributed to the study conception, design, and material preparation. Data collection and analysis were performed by Sara Purvis and Katrina Armstrong. The first draft of the manuscript was written by Sara Purvis and Matthew Tobey. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sara J. Purvis.

Ethics declarations

Ethics Approval

This study was deemed exempt by the Massachusetts General Brigham IRB (#2020P003423) and approved by all required Tribal Review/Health Boards, including approval by the Great Plains Indian Health Service IRB prior to publishing. Consent was obtained from all study participants.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare no competing interests.

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Appendix

Appendix

Table 1 Participant demographics (N = 679)
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Table 2 Vaccination encouragement and discouragement1
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Table 3 COVID-19 vaccination factors (N = 679)
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Table 4 Vaccination encouragement bivariate analysis (N = 679)
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Table 5 Regression model
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Purvis, S.J., Armstrong, K., Isaacson, M.J. et al. Factors Associated with COVID-19 Vaccination Uptake in Great Plains American Indian Communities. J. Racial and Ethnic Health Disparities (2023). https://doi.org/10.1007/s40615-023-01818-9

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