Faculty, Staff and Student Publications

Language

English

Publication Date

8-4-2025

Journal

Vaccine

DOI

10.1016/j.vaccine.2025.127554

PMID

40763395

PMCID

PMC12818904

PubMedCentral® Posted Date

1-21-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Vaccination effectively and safely prevents serious illness from coronavirus disease 2019 (COVID-19). This study examines the complex factors associated with vaccination uptake among economically disadvantaged adults calling the Texas/United Way 2-1-1 helpline. Results informed the development of strategies to increase COVID-19 vaccine uptake among vulnerable populations disproportionately impacted by COVID-19-related morbidity and mortality.

Material and methods: We conducted a cross-sectional survey among 2-1-1 adult callers (May 2021-September 2022). The survey examined demographic, sociocultural, healthcare access, and psychosocial factors, as well as mistrust in health agencies. We used multivariable logistic regression models to examine factors associated with vaccination uptake, and ordinal regression models to examine factors associated with psychosocial constructs significantly related to vaccination outcomes.

Results: The majority of respondents were from low-income households, had low education attainment, and were minorities. Among the 509 surveys, 67.2 % of participants reported vaccine uptake. Multivariable logistic regression analyses indicated significantly higher odds of vaccination among adults 50-64 years and 65 years and over (OR: 4.5, 95 % CI: 1.7-11.7 and OR: 7.2, 95 % CI: 1.8-28; P < 0.01). Respondents with higher scores on perceived susceptibility (OR: 1.4, 95 % CI: 1.0-1.8, p = 0.02), perceived safety of the vaccine (OR: 2.9, 95 % CI: 1.9-4.3, p < 0.01) and beliefs about vaccine effectiveness against COVID-19 (OR: 1.5, 95 % CI: 1.1-2.0, p = 0.02) and serious illness and hospitalization (OR: 1.4, 95 %: 1.0-1.8, p = 0.02) were significantly more likely to have received a vaccination.

Conclusions: Our results indicate that among the sample of economically vulnerable 2-1-1 callers from primarily underserved minority groups, perceived vaccine safety and effectiveness (against COVID-19, serious illness, and hospitalization), and perceived susceptibility to COVID-19 are important factors associated with vaccine uptake. These findings underscore the importance of designing interventions to increase vaccination that address these constructs with powerful messages and strategies.

Keywords

COVID-19, SARS-CoV-2, Vaccine, underserved adults, survey, Psychosocial factors

Published Open-Access

yes

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