Evaluating vaccine hesitancy in transgender and gender diverse patients at a gender-affirming clinic in New Mexico, USA.

OBJECTIVE

This study evaluated vaccine hesitancy (VH) scores in transgender and gender-diverse patients for four vaccines: human papillomavirus (HPV), hepatitis B (HBV), influenza, and COVID-19.

METHODS

A cross-sectional study was conducted at a gender-affirming care clinic in New Mexico, USA. Participants aged >18 years with a diagnosis of gender dysphoria were eligible for inclusion. Participants completed an electronic survey during their clinic visit. Demographic characteristics were collected, and additional survey items were adapted from the Vaccine Hesitancy Scale developed by the SAGE Working Group. Higher VH scores indicated greater hesitancy.

RESULTS

181 participants completed surveys. The mean age was 30.0 years and the majority of participants were white (64.1%). Gender was reported as male (39.8%), female (31.5%), non-binary/non-conforming (24.3%), and prefer not to respond (4.4%). Vaccination rates were: COVID-19 (92.8%), influenza (74.0%), HBV (65.7%), and HPV (61.4%). For all vaccines, overall VH scores were higher (p < 0.01) in the unvaccinated groups. For HBV and influenza vaccines, there were significant differences for each of the 3Cs (confidence, complacency, convenience) between vaccinated and unvaccinated groups (p < 0.001). For HPV, there was a significant difference in confidence (p = 0.03) and convenience (p < 0.01) scores. For COVID-19, there were significant differences in confidence (p < 0.0001) and complacency (p < 0.0001). Hesitancy scores ≥ 2.0 were significantly (p < 0.05) associated with being unvaccinated for all but the HPV vaccine (p > 0.05).

CONCLUSION

Survey responses from unvaccinated participants indicate a higher degree of VH compared to vaccinated participants. Differing VH determinants were associated with unvaccinated status for the HPV, HBV, influenza, and COVID-19 vaccines.