(CN) — When you picture the people at most risk of severe death and disease from Covid-19, you probably picture someone old enough to be your grandparent, and not a person who suffers from a drug addiction.
While both groups fell under multiple high-risk categories, people of grandparent ages recorded the highest rates of vaccination against Covid-19, while people who suffer from drug addictions fell behind. New research is not only analyzing the damaging effects of online misinformation and distrust of doctors during the pandemic but also highlights an unlikely solution: safe syringe sites.
About 185 safe syringe sites operate in 38 states, where drug users trade used needles for clean ones. Proponents say this simple service reduces the spread of infectious diseases like HIV while opening the door for counselling among those seeking to quit.
“I think that meeting people where they're at helps build trust,” said Camille Cioffi, a research associate at the University of Oregon's Prevention Science Institute.
“Where that trust has been built by the syringe exchange program, we can come with the same attitude of humility and say we're not going to tell you that you have to do something, but we want to make sure that you have the opportunity to do it,” Cioffi said.
Even though only 10% of the people surveyed by Cioffi’s team in 2021 had received vaccines, she found most respondents wanted one.
“Given the opportunity, they were as willing as people in the general population to get vaccinated,” Cioffi said. “There’s good research showing the benefits of having these one-stop-shop models, so people don't have to try to ride a bus across town to get to all the different services they need.”
Cioffi’s research helped inspire the HIV Alliance in Eugene, Oregon, to add Covid-19 testing and vaccination to existing HIV prevention and treatment services. The nonprofit exchanges an estimated 2 million syringes annually among 10,000 clients.
“We have a really unique relationship with that community and we have a lot of trust,” said Amanda McCluskey, a senior program director at HIV Alliance in Eugene.
Over the last year, HIV Alliance provided 5,316 Covid-19 tests and 742 vaccines to people who may not have received either without the program. With a new part-time nurse on staff to help inoculate interested clients, HIV Alliance is gearing up to roll out hepatitis and flu vaccines later this year.
“We have some folks who say things like, ‘I don't believe that Covid is real,’ and that's okay, we just want to offer it if folks are interested,” McCluskey said. “One of the things that's been really helpful is having nurses go out to the exchange and talk to folks, not even trying to convince them to get vaccinated, but just to have a conversation about the myths and facts around the vaccine and answering any questions somebody might have.”
Even with these small successes in Oregon and elsewhere, people who inject drugs are particularly vulnerable to adverse health effects from Covid-19 since many suffer from comorbidities and have limited access to healthcare. More than a year after safe and effective vaccines became widely available, the population’s uptake often remains behind the general population.
“Vaccine hesitancy is not simply irrational. Despite the fact there is good efficacy data for vaccination, there is a real historical basis for people's mistrust of healthcare providers that can get lost in the story,” explained Matthew Sullivan, a clinical fellow in psychology at Massachusetts General Hospital and Harvard Medical School.
In 2020, Sullivan contributed to a paper surveying people with opioid use disorders about their willingness to get inoculated against Covid-19 once vaccines were availible.
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