Why might our homeless neighbors be more likely to reject a COVID-19 vaccine?

LA's homeless residents are among those most in need of a COVID-19 vaccine, but new research from the Homeless Research Data Collaborative found that nearly half of homeless survey respondents were reluctant to get vaccinated.

Researchers from UCLA, USC, and Akido Labs are using a first-of-its kind data platform to understand this question and others like it by engaging and learning from people experiencing homelessness in Los Angeles.

Leadership

Benjamin Henwood, PhD

bhenwood@usc.edu

Randall Kuhn, PhD

kuhn@ucla.edu

Karthik Murali, PhD

karthik@akidolabs.com

About Us

The Homeless Research Data Collaborative was launched by researchers from USC, UCLA, and Akido Labs to connect lived expertise, research, and data to better understand the stories and needs of people experiencing homelessness in our communities.

Our team designed a first-of-its-kind platform and worked with people with lived experience to build reciprocal relationships with individuals experiencing homelessness, via monthly online surveys.

This approach allows us to understand the complex needs and daily lives of people whom our communities and systems have failed. By connecting directly with actual people, in a timely way, we can identify patterns, pinpoint barriers, and rapidly mobilize solutions.

Pilot Study Approach

Partnered with a trusted community clinic to connect with people experiencing homelessness

Enrolled individuals experiencing homelessness for a longitudinal cohort study

Established 75% retention through inclusive survey design and engagement methods

Pilot Study Findings

46%

of respondents expressed some level of vaccine hesitancy based either on actual vaccine offers (18%) or a hypothetical question (82%).

These figures are particularly important when compared to the general population, in which vaccine hesitancy hovers below 30%.

Fears and precautions don't necessarily go hand in hand:

Those who most frequently practiced COVID-19 protective behaviors, like wearing masks and social distancing, were more likely to feel hesitant to accept a vaccine.

Information sources play a key role in vaccine acceptance:

Those who trusted official sources on COVID-19 and vaccine information were less hesitant to accept a vaccine.

Those who trusted friends and family for COVID-19 information were more likely to be hesitant.

Applying Lessons from Our Research

Anticipate Hesitation:

Given the physical health, mental health, and social isolation challenges that people experiencing homelessness often face, vaccination efforts must account for possible fears and needs for quality information before offering vaccines.

Utilize Information Networks:

The vaccine-hesitant are less likely to accept information on the vaccine from official sources, but more likely to accept it from friends and family. Utilizing social networks and informal communication to share quality information and experiences can boost acceptance.

Get Specific:

People experiencing homelessness in our community need specific educational and social influence interventions to accept this life-saving vaccine, as the challenging circumstances of daily life can be overlooked. Educators and providers need to account for these unique needs in their vaccination efforts.

Dive Into the Data

Want a closer look at the Vaccine Access and Attitudes data?

Check out our data dashboard here.

Vaccine Hesitancy

Received Vaccine

Understanding Housing Needs

In late 2021, we asked participants in the study about their housing preferences. Evidence has shown that individuals experiencing homelessness are more likely to accept housing and services—and remained housed long-term—when those supports are aligned to the individuals’ unique needs.

Do you have any specific needs or requirements for housing/shelter?

Handicap accessible

12%

Allowed to stay with partner, spouse, or child

22%

Allowed to stay with pets

27%

Needs to be in a particular neighborhood

37%

42%

Storage for possessions

What are some issues that would keep you from moving into a shelter or housing?

Negative interactions with staff

47%

Hours/curfew

50%

Poor cleanliness

55%

Unsafe

59%

60%

Lack of privacy

Out of 132 participants, 52% indicated that they would be interested in receiving supportive housing services.

Additional services that were of interest included temporary stay in hotel/motel (38%), other transitional living (22%), shared living with a roommate (19%), and safe camping (17%).

16% of participants indicated they were not interested in any housing services that were listed on the survey.