Barriers and facilitators of COVID-19 vaccination among drug users: a qualitative analysis for future crisis management
Abstract Introduction People Who Use Drugs (PWUD), are a population at the high risk of exposure to infectious disease and should be considered as a priority for vaccination against communicable diseases. However, during the COVID-19 pandemic this population showed resistance to vaccination. The aim...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12879-025-11248-z |
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| author | Salah Eddin Karimi Sina Ahmadi Neda SoleimanvandiAzar Zahra Rampisheh Marzieh Nojomi Elham Sepahvand Fateh Tavangar Seyed Arash Tehrani-Banihashemi Batool Tayefi Peter Higgs |
| author_facet | Salah Eddin Karimi Sina Ahmadi Neda SoleimanvandiAzar Zahra Rampisheh Marzieh Nojomi Elham Sepahvand Fateh Tavangar Seyed Arash Tehrani-Banihashemi Batool Tayefi Peter Higgs |
| author_sort | Salah Eddin Karimi |
| collection | DOAJ |
| description | Abstract Introduction People Who Use Drugs (PWUD), are a population at the high risk of exposure to infectious disease and should be considered as a priority for vaccination against communicable diseases. However, during the COVID-19 pandemic this population showed resistance to vaccination. The aim of this study was to better understand the barriers and facilitators of COVID-19 vaccination in PWUD in Tehran, Iran. Materials and methods In this qualitative study data were collected through semi-structured interviews with participants through purposeful sampling with maximum variation. The collected data were analyzed using content analysis informed by Graneheim and Lundman using MAXQDA-10 Software. Lincoln and Guba’s criteria were used to ensure the accuracy and validity of the data. Findings Our study results were presented under two main themes: barriers and facilitators to COVID-19 vaccination acceptance among PWUD. Based on the results of this study, the most important barriers to COVID-19 vaccine acceptance were; Stereotyped beliefs (The belief that drug users will not get infected with COVID-19, Ineffectiveness of COVID-19 vaccine, The negative effect of vaccine on underlying disease, Lack of trust in healthcare system and the type of vaccine), Low health literacy and knowledge (Neglecting health and underestimating the disease, Not prioritizing the health, Low health literacy, Believing in self-treatment and traditional medicine, Available rumors), low social capital(including having limited social networks, believing misinformation and perceived powerlessness), Structural and Experiential Barriers (Lack of access to vaccine, Unpleasant past experiences in related with the vaccination), and fear and worry caused by previous experiences(Death or illness of friends/people around who had been vaccinated, Fear of the vaccine). In addition, the most important facilitators of COVID-19 vaccine acceptance can also be classified into 2 categories of The role of incentives and social responsibility(Incentive payments, Social responsibility, Immune system strengthening as a motivation for vaccination) and Rebuilding Trust and Improving Public Perceptions (Compensating for past mistakes, The effect of advertisement by physicians and officials). Conclusion Given the possibility of future pandemics the role of vaccination in the prevention and control of communicable diseases, it is imperative to reduce the most negative consequences of pandemics for the general public and high-risk groups. Barriers to vaccination can be minimized through effective engagement with different social groups the goal of which is to effectively explain the benefits of vaccination. When planned and implemented well this will maintain health and prevent deaths in future pandemics. Health care policymakers can use the results of this study to reduce the barriers to vaccination and encourage high risk social groups to receive vaccination in future pandemics. |
| format | Article |
| id | doaj-art-eb9bc6c1963b4692a6fdab4f6fc1d04b |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-eb9bc6c1963b4692a6fdab4f6fc1d04b2025-08-20T04:01:43ZengBMCBMC Infectious Diseases1471-23342025-07-0125111110.1186/s12879-025-11248-zBarriers and facilitators of COVID-19 vaccination among drug users: a qualitative analysis for future crisis managementSalah Eddin Karimi0Sina Ahmadi1Neda SoleimanvandiAzar2Zahra Rampisheh3Marzieh Nojomi4Elham Sepahvand5Fateh Tavangar6Seyed Arash Tehrani-Banihashemi7Batool Tayefi8Peter Higgs9Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical SciencesSocial Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical SciencesPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesDepartment of Nursing, School of Nursing and Midwifery, Social Determinants of Health Research Center, Lorestan University of Medical SciencesSocial Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical SciencesPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesDepartment of Public Health, La Trobe UniversityAbstract Introduction People Who Use Drugs (PWUD), are a population at the high risk of exposure to infectious disease and should be considered as a priority for vaccination against communicable diseases. However, during the COVID-19 pandemic this population showed resistance to vaccination. The aim of this study was to better understand the barriers and facilitators of COVID-19 vaccination in PWUD in Tehran, Iran. Materials and methods In this qualitative study data were collected through semi-structured interviews with participants through purposeful sampling with maximum variation. The collected data were analyzed using content analysis informed by Graneheim and Lundman using MAXQDA-10 Software. Lincoln and Guba’s criteria were used to ensure the accuracy and validity of the data. Findings Our study results were presented under two main themes: barriers and facilitators to COVID-19 vaccination acceptance among PWUD. Based on the results of this study, the most important barriers to COVID-19 vaccine acceptance were; Stereotyped beliefs (The belief that drug users will not get infected with COVID-19, Ineffectiveness of COVID-19 vaccine, The negative effect of vaccine on underlying disease, Lack of trust in healthcare system and the type of vaccine), Low health literacy and knowledge (Neglecting health and underestimating the disease, Not prioritizing the health, Low health literacy, Believing in self-treatment and traditional medicine, Available rumors), low social capital(including having limited social networks, believing misinformation and perceived powerlessness), Structural and Experiential Barriers (Lack of access to vaccine, Unpleasant past experiences in related with the vaccination), and fear and worry caused by previous experiences(Death or illness of friends/people around who had been vaccinated, Fear of the vaccine). In addition, the most important facilitators of COVID-19 vaccine acceptance can also be classified into 2 categories of The role of incentives and social responsibility(Incentive payments, Social responsibility, Immune system strengthening as a motivation for vaccination) and Rebuilding Trust and Improving Public Perceptions (Compensating for past mistakes, The effect of advertisement by physicians and officials). Conclusion Given the possibility of future pandemics the role of vaccination in the prevention and control of communicable diseases, it is imperative to reduce the most negative consequences of pandemics for the general public and high-risk groups. Barriers to vaccination can be minimized through effective engagement with different social groups the goal of which is to effectively explain the benefits of vaccination. When planned and implemented well this will maintain health and prevent deaths in future pandemics. Health care policymakers can use the results of this study to reduce the barriers to vaccination and encourage high risk social groups to receive vaccination in future pandemics.https://doi.org/10.1186/s12879-025-11248-zPeople who use drugsPWUDSubstance useDrug abusePandemicAddiction |
| spellingShingle | Salah Eddin Karimi Sina Ahmadi Neda SoleimanvandiAzar Zahra Rampisheh Marzieh Nojomi Elham Sepahvand Fateh Tavangar Seyed Arash Tehrani-Banihashemi Batool Tayefi Peter Higgs Barriers and facilitators of COVID-19 vaccination among drug users: a qualitative analysis for future crisis management BMC Infectious Diseases People who use drugs PWUD Substance use Drug abuse Pandemic Addiction |
| title | Barriers and facilitators of COVID-19 vaccination among drug users: a qualitative analysis for future crisis management |
| title_full | Barriers and facilitators of COVID-19 vaccination among drug users: a qualitative analysis for future crisis management |
| title_fullStr | Barriers and facilitators of COVID-19 vaccination among drug users: a qualitative analysis for future crisis management |
| title_full_unstemmed | Barriers and facilitators of COVID-19 vaccination among drug users: a qualitative analysis for future crisis management |
| title_short | Barriers and facilitators of COVID-19 vaccination among drug users: a qualitative analysis for future crisis management |
| title_sort | barriers and facilitators of covid 19 vaccination among drug users a qualitative analysis for future crisis management |
| topic | People who use drugs PWUD Substance use Drug abuse Pandemic Addiction |
| url | https://doi.org/10.1186/s12879-025-11248-z |
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