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Abstract
Veterans experiencing homelessness are particularly at risk from infection and transmission from COVID-19, and vaccines offer a promising avenue toward reducing that risk. However, little is understood about vaccine acceptance within the homeless population, particularly Veterans experiencing homelessness, who comprise a disproportionate share of that population. The cultural roots of vaccine hesitancy among active-duty military members and Veterans are even less understood. This study used semi-structured interviews to explore the role of military identity in shaping the vaccination attitudes of 20 Veterans experiencing homelessness enrolled in U.S. Department of Veterans Affairs’ (VA) transitional housing programs. Over half of the Veteran respondents mentioned their military experience during interviews about the COVID-19 vaccines. In these discussions, they cited mandatory vaccines in the military, military identity, and distrust of the military or government. Distrust was cited by most refusing the vaccine, while mandatory vaccines in the military were cited by most accepting the vaccine. Military identity, culture, and experience influence the risk-benefit reasoning that man Veterans in VA homeless programs undertake when deciding whether to accept the COVID-19 vaccine. A more nuanced understanding of military culture’s effect on Veterans experiencing homelessness is vital in designing messages and strategies that encourage vaccine uptake.
Data availability statement
The datasets generated and/or analyzed during the current study are not publicly available. They are available from the corresponding author on reasonable request, subject to approval from the ethics committee that approved the study.
Disclosure statement
The authors declare that they have no financial conflicts of interests.
The views expressed are solely those of the authors and do not reflect the official policy or position of the U.S. Department of Veterans Affairs nor the U.S. government.
Ethics approval and consent to participate
This study was reviewed by the VA Greater Los Angeles Healthcare System Institutional Review Board and determined to be a quality improvement study. All methods were carried out in accordance with relevant guidelines and regulations. Verbal informed consent was obtained from each participant prior to study inclusion. Involvement in the study was voluntary and there were no repercussions for nonparticipation. Anonymity and confidentiality of the information was maintained by removing personal identifiers from the data. The notes and audio tapes are kept in secured password protected electronic device accessible only to the first author and the coauthors.
Funding
This study was funded by the U.S. Department of Veterans Affairs. The funder did not participate in the design of the study, collection, analysis, and interpretation of data or writing this manuscript.