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Vaccine refusal rate at 3% among veterans, slightly higher in rural areas

Laureen Crews, a U.S. Army veteran, was the 10,000th veteran to be vaccinated against COVID-19 at Harry S. Truman Memorial Veterans' Hospital in Missouri.

VA

By NIKKI WENTLING | STARS AND STRIPES Published: April 1, 2021

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WASHINGTON — About 3% of veterans have refused coronavirus vaccines when offered them by the Department of Veterans Affairs — an amount lower than the agency anticipated, a VA official said Thursday.

The refusal rate is slightly higher in less populated areas, equating to 4% among veterans in rural places and 5% in areas designated as highly rural. Refusal rates are lower among the populations of Black and Hispanic veterans.

“We were worried we’d see more vaccine hesitancy and disparities across different groups, and we’re pleasantly surprised we’re not seeing that in large part, at least so far,” said Dr. Ernes Moy, executive director of the VA Office of Health Equity. “We are concerned about rural rates — that seems to be the biggest disparity that’s out there that we need to address.”

In his role, Moy coordinates efforts to reduce disparities in health care among veterans. In the summer, his office began holding focus groups with different demographics of veterans, asking them about their hesitancy to get a coronavirus vaccine.

Based on what they learned during the swine flu pandemic in 2009, veterans of color were more likely to be hesitant about receiving vaccines. For the VA, that was a “major concern,” Moy said. During the focus groups, the VA learned Black veterans wanted to hear scientific evidence about the vaccines from their health care providers.

Black veterans also wanted the department to address the “Tuskegee experiment” — a study that has led many Black Americans to mistrust medical systems. The U.S. Public Health Service, working with the Tuskegee Institute in Alabama, recruited hundreds of rural Black men for a study of syphilis in 1932, and then withheld medical treatment from them.

“They said we couldn’t just pretend Tuskegee didn’t happen. We got the advice that we needed to address it,” Moy said. “[With Tuskegee], they were denied the right to make a choice for themselves and not offered treatment. We see this as the exact opposite situation. We’re offering a vaccination, this isn’t research.”

Veterans also advised the VA to make it as easy as possible to sign up for a vaccination and communicate by calling or texting. When VA patients are eligible to receive a vaccine, they get a call from a VA health care provider who schedules their appointments over the phone, Moy said.

As of Thursday, the VA had fully vaccinated about 1.9 million people. About 45% of VA patients ages 75 and older had been vaccinated, as well as 42% of patients between 65 and 74, and 25% of patients ages 64 and younger.

Black and Hispanic veterans older than 75 have been vaccinated at a slightly higher rate — 50% had been vaccinated as of Thursday.

“We continue to see higher rates of vaccination among Black and Hispanic veterans than among white veterans,” Moy said.

The largest disparity in refusal rates is between urban and rural veterans, Moy said. However, the difference is at least in part due to the lack of availability of vaccines in rural places, he said. The VA has found some rural veterans are refusing vaccines because they don’t want to make the long drive to a VA facility to receive one.

As vaccines become more widely available, the department expects refusals to drop.

“A refusal means, ‘I don’t want to have a vaccine at this time,’” Moy said. “When we get more vaccines to rural areas, we expect the refusal rate to decline.”

So far, it’s difficult to compare the refusal rates among VA patients to the larger U.S. population because many other health care systems aren’t tracking refusals, Moy said. In the instances that they are tracked, they aren’t broken down by demographics such as age and race, he said.

President Joe Biden and his administration have cited concerns about the spread of myths and misinformation about coronavirus vaccines. On Thursday, the administration unveiled its first television advertisements to encourage Americans to get vaccinated.

Vice President Kamala Harris and Surgeon General Vivek Murthy on Thursday also launched a “Covid-19 Community Corps,” a group of local leaders and prominent organizations who were recruited to help inform and encourage Americans who might be hesitant to receive a vaccine. Representatives from national veterans organizations were included in the group.

“We have to be honest that in some communities, there is a concern about getting vaccinated, some based on mistrust based on history, some based on — just rooted in misinformation, of which there is a lot out there,” Harris told the group Thursday. “But no matter the community, trusted leaders are the best way to boost confidence. And trusted leaders — you — are the best way to deliver information.”

The VA is also working to combat some myths about the vaccine, including one falsehood about it causing infertility among women. The department put out information on its website titled “Debunking Common Covid-19 Vaccine Myths.”

A group of senators believe the VA could be doing more. Last week, Sens. Amy Klobuchar, D-Minn., and Rob Portman, R-Ohio, sent a letter to VA Secretary Denis McDonough urging him to ramp up efforts to combat misinformation about vaccines. Twelve other senators signed onto the letter.

The senators cited a poll of 810 service members, veterans and spouses conducted by Blue Star Families in December. Half of the veteran families polled said they did not plan to get vaccines because they were concerned about their safety and efficacy.

The senators asked McDonough to use some of the funds Congress allocated to the VA last year through the Coronavirus Aid, Relief, and Economic Security Act to counter vaccine misinformation.

“It is crucial that veterans receive clear and accurate information about the vaccine and your agency can play a major role in helping them identify false information and recognize the safety and efficacy of the vaccines,” they wrote.

wentling.nikki@stripes.com
Twitter: @nikkiwentling