576. Determinants of COVID-19 Vaccine Hesitancy: A Cross-Sectional Study in 3 Communities in the United States and Lebanon

Abstract Background The ongoing COVID-19 pandemic has thus far resulted in substantial worldwide mortality. As of November 2020, COVID-19 vaccines became available following Emergency Use Authorization (EUA) issued by the FDA. Recent longitudinal studies published as of March 2021 demonstrated that vaccine hesitancy remains high despite improvements compared to 2020. This study sought to explore the perceptions, beliefs, attitudes, and knowledge surrounding COVID-19 and identify determinants uniquely associated with vaccine hesitancy. Methods A cross-sectional electronic survey was created based on CDC & IDSA recommendations. The survey was distributed from March 2021 until June 2021 randomly to faculty members, healthcare workers, and students (≥18 years old) across 3 major academic centers (Case Western Reserve University, Spectrum Health, and the American University of Beirut Medical Center [AUBMC]). Data collected included socio-economic characteristics, demographics, knowledge, and attitudes pertaining to COVID-19 and vaccination. A multivariable regression model was utilized to evaluate for independent associations between variables and vaccination willingness/hesitancy as the primary outcome. Results In total, 7,197 participants completed the survey with an overall response rate of 94%. Females constituted 75.7% of the study population. Overall, 87.8% of the study cohort indicated willingness to get vaccinated. Factors associated independently with vaccination hesitancy included: younger age, lower attained education, lower knowledge score, physician recommendation against vaccination, not receiving the influenza vaccine annually, and other beliefs and attitudes as reported in table 1. Table 1. Independent predictors of COVID-19 vaccine hesitancy among study respondents Conclusion Most survey respondents indicated willingness to receive COVID-19 vaccination. The perception or belief that vaccination is more harmful than COVID-19 disease represented an especially robust barrier against vaccination. Since recommendations made by healthcare providers were strongly associated with either vaccination hesitancy or willingness to get vaccinated, developing educational strategies at this level could enhance vaccine acceptance in an effort to curb the pandemic. Disclosures Robert A. Bonomo, MD, entasis (Research Grant or Support)Merck (Grant/Research Support)NIH (Grant/Research Support)VA Merit Award (Grant/Research Support)VenatoRx (Grant/Research Support)


Conclusion.
HIV patients offered SARS CoV2 vaccine by County HIV clinic staff with established patient care relationships had high vaccine acceptance (80%), comparable to 68% series completion in the county overall and 56% in the health equity quartile county census tracts. Latino HIV infected persons were most likely to complete the COVID vaccine series. Ryan White funded HIV clinics are ideal hubs to coordinate HIV patient COVID vaccination efforts. Adding COVID vaccine completion to HIV clinic performance measures would likely be beneficial.
Disclosures. Background. SARS-CoV-2 the etiology of COVID-19 has caused more than 33 million cases and almost 600,000 deaths in the United States alone. Vaccination is a vital tool in controlling the pandemic. With accelerated infection rates in various parts of the world, the incidence of variants has risen and threatens to set back the long sought after immunity, provided by available vaccines. The objective of this study was to evaluate the breakthrough infection rate after complete vaccination, in Sangamon County, with a rural and urban population of 195,000 in Central Illinois.
Methods. Data regarding breakthrough infections collected from the Sangamon County Department of Public Health, included the total number of infections, time after vaccination, age range of those infected and the type of vaccine used. Complete vaccination was defined as 14 days after the single dose of Johnson & Johnson/Janssen or the second dose of Pfizer-BioNTech or Moderna Inc. vaccine.
Results. The number of fully vaccinated individuals at the time of writing of this study was 87,086 which corresponded to 44.58 % of the total population. The breakthrough infection percentage was calculated as 0.036%. The mean time after vaccination to infection was 49.13 days with a standard deviation of 23.28.

Conclusion.
Breakthrough infections among fully vaccinated individuals in our county, have been quite rare, which points to the high efficacy of the vaccines. A complex number of factors likely contribute to this including virus-related factors i.e. variant forms and specific patient-related factors which are not a part of this study. The afore-mentioned high efficacy rate of the vaccines provides further justification, to continue to pursue a persistent vaccination strategy to mitigate the effects of the SARS-CoV-2 virus.
Disclosures. All Authors: No reported disclosures Background. The ongoing COVID-19 pandemic has thus far resulted in substantial worldwide mortality. As of November 2020, COVID-19 vaccines became available following Emergency Use Authorization (EUA) issued by the FDA. Recent longitudinal studies published as of March 2021 demonstrated that vaccine hesitancy remains high despite improvements compared to 2020. This study sought to explore the perceptions, beliefs, attitudes, and knowledge surrounding COVID-19 and identify determinants uniquely associated with vaccine hesitancy.

Methods.
A cross-sectional electronic survey was created based on CDC & IDSA recommendations. The survey was distributed from March 2021 until June 2021 randomly to faculty members, healthcare workers, and students (≥18 years old) across 3 major academic centers (Case Western Reserve University, Spectrum Health, and the American University of Beirut Medical Center [AUBMC]). Data collected included socio-economic characteristics, demographics, knowledge, and attitudes pertaining to COVID-19 and vaccination. A multivariable regression model was utilized to evaluate for independent associations between variables and vaccination willingness/hesitancy as the primary outcome.
Results. In total, 7,197 participants completed the survey with an overall response rate of 94%. Females constituted 75.7% of the study population. Overall, 87.8% of the study cohort indicated willingness to get vaccinated. Factors associated independently with vaccination hesitancy included: younger age, lower attained education, lower knowledge score, physician recommendation against vaccination, not receiving the influenza vaccine annually, and other beliefs and attitudes as reported in table 1. Table 1. Independent predictors of COVID-19 vaccine hesitancy among study respondents Conclusion. Most survey respondents indicated willingness to receive COVID-19 vaccination. The perception or belief that vaccination is more harmful than COVID-19 disease represented an especially robust barrier against vaccination. Since recommendations made by healthcare providers were strongly associated with either vaccination hesitancy or willingness to get vaccinated, developing educational strategies at this level could enhance vaccine acceptance in an effort to curb the pandemic.