COVID-19 Vaccination Rate Low Among Patients With Vision, Hearing Impairment

COVID-19 vaccine initiation rates are lower among adults with vision or hearing disabilities compared with adults without these impairments, according to a study published in JAMA Ophthalmology. Researchers report that findings are due, in part, to the fact that few state vaccination plans prioritize adults with vision or hearing impairment. This data may lead to future initiatives to promote equitable and accessible vaccinations, according to the research.

In this cross-sectional study, the investigators analyzed data from the US Census Bureau Household Pulse Survey from April 2021 to March 2022. They assessed COVID-19 vaccine initiation, completion, and factors of access, including demographic and clinical characteristics and social determinants of health. 

Visual and hearing impairment was analyzed by patient responses to the question ‘Do you have difficulty seeing/hearing, even when wearing glasses/hearing aids?’ Participants were asked to respond using 1 of 3 answers to determine severity: ‘no to little difficulty,’ ‘serious difficulty, even with glasses/hearing aids,’ and ‘cannot see/hear at all,’ defined as ‘blindness’ and ‘deafness,’ respectively. 

A total of 916,085 adults (mean age, 54.0±15.9 years, 52.0% women, 48.0% men) partook in the survey. Most participants (82.7%) initiated the vaccine and most who initiated COVID-19 vaccination completed the series (98.3%). 

The researchers identified visual and hearing disabilities in 3.8% and 2.5% of the participants, respectively. COVID-19 vaccine rates were significantly lower for adults who answered ‘cannot see/hear at all.’ (62.9% and 65.2%, respectively) compared with adults with no to little vision or hearing impairment (83.0% and 80.7%, respectively). 

Adults with blindness (mean difference, -6.3%, -11.1% to -1.5%; P =.009) and deafness (mean difference, -5.5% [-9.2% to -1.9%]; P =.003) were less likely to initiate COVID-19 vaccine compared with adults with little to no visual or hearing impairment, respectively. Adults with serious difficulty hearing and deafness had similar results to initiate the COVID-19 vaccine. Adults with 2 or more disabilities (-2.4% [-3.7% to -1.2%]; P <.001) were less likely to initiate the vaccine compared with adults with 1 or fewer disabilities. 

“Few state vaccination plans have prioritized adults with vision or hearing disabilities; furthermore, vaccination among adults with disabilities has been neglected in data collection efforts,” the researchers explain. “Additional research may be needed to monitor COVID-19 vaccination disparities among adults with vision or hearing disabilities and to address disparities (e.g., accessibility of vaccine registration sites and public COVID-19 related broadcasts for individuals with vision or hearing disabilities).”

The primary limitations were that lack of information on comorbidities/disabilities and the underestimation of individuals with hearing impairment or deaf.