S898 Socioeconomic Factors, Not Disease Severity or Treatment Regimen, Most Important in Identifying COVID-19 Vaccine Hesitant IBD Patients

Introduction: Successful recovery from the COVID-19 pandemic relies on widespread vaccine acceptance. While uptake has improved over recent months, hesitancy and skepticism persist, including in populations who could most benefit from vaccination such as the elderly, chronically ill or those on immunosuppressants. This survey study aims to characterize attributes that correlate and possibly determine vaccine intent or hesitancy among our IBD population. Methods: Subjects were invited to participate in a web-based survey using a patient database from an academic IBD clinic. Survey questions covered disease history, medications, changes to medications and disease management during the COVID-19 pandemic, as well as social, economic, and household characteristics. Positive vaccine intent was defined as having either received a COVID-19 vaccine or planning to do so when it would become available for the participant's age group. Vaccine hesitancy was defined as not having received any portion of a COVID-19 vaccine and not intending to do so. Chi square and logistic binomial regression analysis was performed using SPSS. Results: Of 609 patients invited, 278 (45.6%) completed the survey. 234 (84.2%) had positive vaccine intent;44 (15.8%) were vaccine hesitant. Significant factors are highlighted in Table 1 and were almost exclusively socio-economic. Positive vaccine intent associated variables included college education or above (OR 2.5, p .026), annual income over $150,000 (OR 3.295, p .015), Democratic affiliation (OR 7.193, p<001), CDC information source (OR 5.749, p<.001), and receiving the flu shot in the year prior (OR 3.702, p .002). Variables associated with vaccine hesitancy included African American race (OR .175 p .005), COVID-related financial hardship (OR .480 p .047), in-person employment (OR .403 p .025), and Republican affiliation (OR .259 p .011). Disease-related attributes, comorbidities, or use of immunomodulating drugs were not found to significantly associate with either positive vaccine intent or hesitancy. Discontinuation of biologics during the pandemic was associated with negative vaccine intent, but this relationship disappeared when controlling for race. Conclusion: Vaccine decision making in our population is largely driven by socioeconomic factors, rather than clinical or disease attributes, including among those on immunosuppressant medications. This is important to explore and can help inform public health campaigns when addressing vaccine hesitancy in the community.