# Factors associated with SARS-CoV-2 vaccine hesitancy after stroke: a cross-sectional study

## TL;DR

This study finds that many stroke patients are hesitant to get vaccinated against SARS-CoV-2, mainly due to concerns about side effects and physical limitations.

## Contribution

The study identifies specific risk factors for vaccine hesitancy among post-stroke patients using a multi-center observational approach.

## Key findings

- 60.6% of post-stroke patients completed the full SARS-CoV-2 vaccination, while 24.8% remained unvaccinated.
- Advanced age, lower functional independence, and mobility issues were significant risk factors for vaccine hesitancy.
- Most adverse reactions were minor, with no severe cases reported among vaccinated patients.

## Abstract

The vaccination status of post-stroke patients, who are at high risk of severe outcomes from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is a significant concern, yet it remains unclear. We aimed to explore the vaccination status, factors associated with vaccine hesitancy, and adverse effects after vaccination among post-stroke patients.

This multi-center observational study enrolled hospitalized post-stroke patients from six Chinese hospitals (Oct 1, 2020 - Mar 31, 2021), examining vaccine uptake and self-reported reasons for vaccine hesitancy, utilizing logistic regression to investigate risk factors for vaccine hesitancy, and recording any adverse reactions post-vaccination.

Of the total 710 post-stroke patients included in the study, 430 (60.6%) had completed the recommended full-3 dose SARS-CoV-2 vaccination, with 176 (24.8%) remaining unvaccinated. The most common reasons for vaccine hesitancy were concerns about vaccine side effects (41.5%) and impaired mobility (33.9%). Logistic regression identified advanced age (aOR = 1.97, 95%CI: 1.36–2.85, P = 0.001), lower Barthel Index score (aOR = 0.88, 95%CI: 0.82–0.93, P = 0.018), higher Modified Rankin Scale score (aOR = 1.85, 95%CI: 1.32–2.56, P = 0.004), and poorer usual activity level of EuroQol 5-Dimension (aOR = 2.82, 95%CI: 1.51–5.28, P = 0.001) as independent risk factors for vaccine hesitancy. Approximately 14.8% reported minor adverse reactions, mainly pain at the injection site.

We found that post-stroke patients have insufficient SARS-CoV-2 vaccination rates, with key risk factors for vaccine hesitancy including concerns about side effects, advanced age, and functional impairments. No severe adverse reactions were observed among the vaccinated population.