UM study explores vaccine hesitancy in Montana

As the delta variant grips the nation, understanding the “why” behind Montanans choosing to get vaccinated — or not — is the topic of a National Institutes of Health grant to the University of Montana’s Center for Population Health Research.

Led by Sophia Newcomer, assistant professor of epidemiology in the School of Public and Community Health Sciences, housed in UM’s College of Health, the grant will investigate the many factors influencing Montanans about their confidence — or hesitancy — when it comes to the state’s Covid-19 vaccination rates, or Montana’s overall vaccine uptake.

The $280,000 one-year grant includes Missoula’s All Nation’s Health Center, UM’s School of Social Work and UM students, who will collectively work to gauge the many factors surrounding how Montanans approach the vaccine and what particular messaging might influence their choice to get vaccinated.

About 53% of Montanans have received at least one dose of the vaccine, according to the Centers for Disease Control and Prevention.

“Compared to urban areas, there’s very little research about vaccine uptake in rural and Indigenous populations,” Newcomer said. “We’re hoping to learn more about influencing factors when it comes to the vaccine, so that we can help Montana health care providers increase vaccine confidence with their patients.”

To do that, a multifaceted approach that heavily involves UM students, will drive two main components of the project. The first is a qualitative research study led by UM social work faculty and students, who will gather information about the vaccine from the perspective of rural and Indigenous Montanans. The second is a statewide survey of Montana primary health care providers that will examine what kind of questions and hesitation they see from patients in clinical settings.

Faculty and graduate students in social work will lead the component of interviewing Montanans about their health choices and beliefs behind their concerns about vaccines. UM public health students will analyze the survey’s data, which will help inform messaging to Montana health care providers statewide.

“The project is one year because of the urgency of the problem,” said Curtis Noonan, CPHR director. “Our most urgent need is to promote the uptake of the Covid-19 vaccine for Native Americans and our rural citizens and to then inform how providers can best communicate with patient populations as we live with SARS-COV-2 into the future.”

Skye McGinty, executive director of All Nations Health Center, said despite some Montana reservation communities having high vaccine update percentages — some near 80% — the vaccine uptake in the state’s Indigenous population is still low and that retrieving accurate numbers when it comes to race and vaccine choice is difficult.

“Working with UM will allow us to take a deeper dive into the decision-making process of why or why not people are choosing to get vaccinated and understand more about barriers — whether that’s a belief system or access to information,” McGinty said. “Ultimately, we want to know what is holding up people to becoming vaccinated.”

McGinty said for many Indigenous people, there’s a host of reasons for vaccine indecision. Some of those factors include a deep mistrust of government and medical facilities linked to historical misuse and abuse by government and medical facilities, racism and systemic oppression, which have long sustained health disparities in Native communities.

She said leveraging the community infrastructure of All Nations and UM doctoral students who work at All Nations, builds trustworthiness into the project as an Indigenous-led effort that is intertribal by nature.

“Data is people,” she said. “And we have to meet them where they are. If we can find out if the challenges of vaccine hesitancy are messaging or community trust, then that’s a potential game changer when it comes our best defense at slowing the spread and overwhelming our schools, health care personnel and facilities.”

Newcomer said the data and insights gleaned from the project are not only immediately relevant but also will provide a critical roadmap for public health for the long-term future.

“When we think about what’s next, there may be booster shots and vaccines for new variants. If we can understand what the gaps are, we have a better chance at increasing vaccine uptake now and into the future,” Newcomer said. “Moving forward, this is long-term problem to figure out how we can most effectively provide vaccines to diverse populations.”

UM began offering an undergraduate degree in public health last year in addition to masters and doctoral degrees. Newcomer, who joined the UM faculty three years ago, comes from a former role collaborating with the CDC on vaccine safety research. Newcomer also studies undervaccination in Montana children.

She said public health research in response to the pandemic is “dynamic and exciting” — particularly for the UM’s “many strong graduate and undergraduate programs that give UM students a front-row seat.”