Chronic diseases: Perceptions about Covid-19 risk and vaccination

Ricotta, Emily E.; Kwan, Jennifer L.; Smith, Brianna A.; Evans, Nicholas G.

BACKGROUND: Individuals with chronic disease may be at higher risk of dying from COVID-19, yet no association has been established between chronic illness and COVID-19 risk perception, engagement with nonpharmaceutical interventions (NPIs), or vaccine acceptance. METHODS: We surveyed US residents who self-reported a chronic respiratory or autoimmune disease in February 2021. Respondents reported beliefs about the risk of COVID-19 to personal and public health, adoption and support of NPIs, willingness to be vaccinated against COVID-19, and reasons for vaccination willingness. We evaluated the association between disease status and COVID-19 behaviors or attitudes, adjusting for demographic and political factors. RESULTS: Compared to healthy controls, chronic disease was associated with increased belief that COVID-19 was a personal (Respiratory = 0.12, 95% confidence interval (CI) = 0.10 – 0.15; Autoimmune = 0.11, CI = 0.08 – 0.14) and public threat (Respiratory = 0.04, CI = 0.02 – 0.06; Autoimmune = 0.03, CI = 0.01 – 0.06), and support for NPIs. Chronic respiratory disease was associated with willingness to be vaccinated (0.6, CI = 0.05 – 0.09). Personal protection was associated with vaccination (Respiratory = 1.08, CI = 1.03 – 1.13; Autoimmune = 1.06, CI = 1.01 – 1.11). Autoimmune disease was associated with fear of a bad vaccine reaction (1.22, CI = 1.06 – 1.41) among those unwilling to be vaccinated. CONCLUSIONS: In the US, chronic disease status is significantly related to risk perceptions of COVID, support of personal and community risk mitigation measures, and willingness to be vaccinated.