Prevalence and Determinants of Reluctance for Regular COVID-19 Vaccination among Primary Health Care patients with COPD and asthma in Greece

Introduction: The appearance of new coronavirus mutations and indications of fading immunity provided by COVID-19 vaccines highlights the importance of regular vaccination. Nonetheless, there is a lack of information regarding people's hesitance towards getting regular COVID-19 vaccinations, especially in patients with asthma and COPD. Therefore, we aimed to examine the prevalence and factors influencing reluctance towards receiving regular COVID-19 vaccinations in patients with asthma and COPD attending primary care. Method: A cross-sectional study was conducted in six primary health care centers during a 3-month period (October 2023-December 2023) in Crete, Greece. Patients with a physician-diagnosis of asthma and COPD completed a questionnaire including socio-demographic characteristics, health status factors, previous COVID-19 vaccination, attitudes and beliefs about COVID-19 vaccination. Multivariate logistic regression was used to identify factors influencing reluctance towards regular COVID-19 vaccination, adjusting for confounding factors. Results: Out of the 216 respondents, 91% reported being vaccinated against COVID-19, with 90% of these individuals having received at least three doses. Among the participants, 43% expressed their willingness to receive the COVID-19 vaccine again, whereas 57% showed reluctance towards getting vaccinated. For the patients willing to be vaccinated, main factors motivating them were older age (OR = 4.81 95% CI 0.91-25.3; p=0.034), presence of cardiovascular disease (OR = 6.31, 95% CI 1.10–39.62; p =0.04), and the recommendation from treating physician (OR = 9.32, 95% CI 1.59-54.54; p<0.001). Conversely, individuals who declined to receive the repeat dose of the vaccine often experienced concerns about potential side effects (OR = 2.93, 95% CI 1.01-8.59; p=0.039). Discussion: Our results suggest that recommendation from the treating physician followed by presence of cardiovascular disease, age and fear of vaccine side effects should be considered for future strategies appropriately tailored to decrease hesitancy for regular COVID-19 vaccination and cope with future pandemics in patients with COPD and asthma.