{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:10:40Z","timestamp":1788307840282,"version":"build-2803163510"},"reference-count":34,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:00:00Z","timestamp":1688342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["U2C DA050098"],"award-info":[{"award-number":["U2C DA050098"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["UG1DA050066"],"award-info":[{"award-number":["UG1DA050066"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The University of Chicago Bucksbaum Institute for Clinical Excellence","award":["U2C DA050098"],"award-info":[{"award-number":["U2C DA050098"]}]},{"name":"The University of Chicago Bucksbaum Institute for Clinical Excellence","award":["UG1DA050066"],"award-info":[{"award-number":["UG1DA050066"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Two parallel public health epidemics affecting the United States include the COVID-19 pandemic and a rise in substance use disorders (SUDs). Limited research has examined the potential relationship between these two epidemics. Our objective was therefore to perform an exploratory study in order to examine the association between public stigma toward people with a past history of opioid, methamphetamine, cocaine, and alcohol use disorder and COVID-19 vaccine hesitancy. A national sample of U.S. adults (N = 6515) completed a survey which assessed the degree of negative perceptions toward individuals with a past history of substance use disorders (referred to as substance use stigma) and COVID-19 vaccine hesitancy, along with variables such as racial prejudice, source of health news, and other demographics. We evaluated four multivariable logistic regression models to predict COVID-19 vaccine hesitancy, utilizing substance use stigma toward opioids, methamphetamine, cocaine, and alcohol use as independent variables. We found that COVID-19 vaccine hesitancy was positively associated with substance use stigma toward opioid (AOR = 1.34, p &lt; 0.05), methamphetamine (AOR = 1.40, p &lt; 0.01), and cocaine (AOR = 1.28, p &lt; 0.05) use, but not alcohol use (AOR = 1.06, n.s.). Predictive models that incorporate substance use stigma may therefore improve our ability to identify individuals that may benefit from vaccine hesitancy interventions. Future research to understand the underlying reasons behind the association between substance use stigma and COVID-19 vaccine hesitancy may help us to construct combined interventions which address belief systems that promote both substance use stigma and vaccine hesitancy.<\/jats:p>","DOI":"10.3390\/vaccines11071194","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T08:25:24Z","timestamp":1688545524000},"page":"1194","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Relationship between Substance Use Stigma and COVID-19 Vaccine Hesitancy"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9454-7503","authenticated-orcid":false,"given":"Natasha","family":"Powell","sequence":"first","affiliation":[{"name":"Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8115-1438","authenticated-orcid":false,"given":"Bruce","family":"Taylor","sequence":"additional","affiliation":[{"name":"NORC at the University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Hotton","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Public Health, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phoebe","family":"Lamuda","sequence":"additional","affiliation":[{"name":"NORC at the University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Flanagan","sequence":"additional","affiliation":[{"name":"NORC at the University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pyra","sequence":"additional","affiliation":[{"name":"Department of Medical Social Sciences, Northwestern University, Evanston, IL 60201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell","family":"Brewer","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3049-924X","authenticated-orcid":false,"given":"O\u2019Dell","family":"Johnson","sequence":"additional","affiliation":[{"name":"Southern Public Health and Criminal Justice Research Center, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1629-1175","authenticated-orcid":false,"given":"Harold A.","family":"Pollack","sequence":"additional","affiliation":[{"name":"Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Public Health, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,3]]},"reference":[{"key":"ref_1","unstructured":"(2022, October 03). Cumulative Cases. Available online: https:\/\/coronavirus.jhu.edu\/data\/cumulative-cases."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/YCO.0000000000000351","article-title":"Stigma and Substance Use Disorders: An International Phenomenon","volume":"30","author":"Yang","year":"2017","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_3","unstructured":"(2022, October 03). Products\u2013Vital Statistics Rapid Release\u2013Provisional Drug Overdose Data, Available online: https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"109150","DOI":"10.1016\/j.drugalcdep.2021.109150","article-title":"Alcohol and Other Substance Use during the COVID-19 Pandemic: A Systematic Review","volume":"229","author":"Roberts","year":"2021","journal-title":"Drug Alcohol. Depend."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Solopov, P.A. (2023). COVID-19 Vaccination and Alcohol Consumption: Justification of Risks. Pathogens, 12.","DOI":"10.3390\/pathogens12020163"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"106754","DOI":"10.1016\/j.addbeh.2020.106754","article-title":"Substance Use and Abuse, COVID-19-Related Distress, and Disregard for Social Distancing: A Network Analysis","volume":"114","author":"Taylor","year":"2021","journal-title":"Addict. Behav."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"ofab285","DOI":"10.1093\/ofid\/ofab285","article-title":"Evaluation of Bundled Interventions for Patients With Opioid Use Disorder Experiencing Homelessness Receiving Extended Antibiotics for Severe Infection","volume":"8","author":"Beieler","year":"2021","journal-title":"Open Forum. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1001\/jama.2022.2404","article-title":"Widespread Misinformation About Infertility Continues to Create COVID-19 Vaccine Hesitancy","volume":"327","author":"Abbasi","year":"2022","journal-title":"JAMA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1038\/s41591-022-01728-z","article-title":"An Epidemic of Uncertainty: Rumors, Conspiracy Theories and Vaccine Hesitancy","volume":"28","author":"Pertwee","year":"2022","journal-title":"Nat. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1176\/appi.ps.201600056","article-title":"Social Stigma toward Persons With Prescription Opioid Use Disorder: Associations With Public Support for Punitive and Public Health\u2013Oriented Policies","volume":"68","author":"Barry","year":"2017","journal-title":"Psychiatr. Serv."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1037\/sah0000374","article-title":"Opioid Addiction, Attributions, and Stigma: An Online Vignette Experimental Study","volume":"7","author":"Ragsdale","year":"2022","journal-title":"Stigma Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"107034","DOI":"10.1016\/j.ypmed.2022.107034","article-title":"Support for Evidence-Informed Opioid Policies and Interventions: The Role of Racial Attitudes, Political Affiliation, and Opioid Stigma","volume":"158","author":"Pyra","year":"2022","journal-title":"Prev. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"113638","DOI":"10.1016\/j.socscimed.2020.113638","article-title":"Correlates and Disparities of Intention to Vaccinate against COVID-19","volume":"272","author":"Callaghan","year":"2021","journal-title":"Soc. Sci. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1177\/1948550620940539","article-title":"Political Ideology Predicts Perceptions of the Threat of COVID-19 (and Susceptibility to Fake News About It)","volume":"11","author":"Calvillo","year":"2020","journal-title":"Soc. Psychol. Personal. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Sallam, M., Dababseh, D., Eid, H., Hasan, H., Taim, D., Al-Mahzoum, K., Al-Haidar, A., Yaseen, A., Ababneh, N.A., and Assaf, A. (2021). Low COVID-19 Vaccine Acceptance Is Correlated with Conspiracy Beliefs among University Students in Jordan. Int. J. Env. Res. Public Health, 18.","DOI":"10.3390\/ijerph18052407"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Gu, M., Taylor, B., Pollack, H.A., Schneider, J.A., and Zaller, N. (2022). A Pilot Study on COVID-19 Vaccine Hesitancy among Healthcare Workers in the US. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0269320"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1177\/0020764014562051","article-title":"Comparing Stigmatising Attitudes towards People with Substance Use Disorders between the General Public, GPs, Mental Health and Addiction Specialists and Clients","volume":"61","author":"Brouwers","year":"2015","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_18","unstructured":"Montgomery, R., Dennis, J.M., and Ganesh, N. (2022, July 23). Response Rate Calculation Methodology for Recruitment of a Two-Phase Probability-Based Panel: The Case of AmeriSpeak. 6p. Available online: https:\/\/www.norc.org\/content\/dam\/norc-org\/pdfs\/WhitePaper_ResponseRateCalculation_AmeriSpeak_2016.pdf."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.jsat.2019.01.005","article-title":"A New Brief Opioid Stigma Scale to Assess Perceived Public Attitudes and Internalized Stigma: Evidence for Construct Validity","volume":"99","author":"Yang","year":"2019","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/BF02310555","article-title":"Coefficient Alpha and the Internal Structure of Tests","volume":"16","author":"Cronbach","year":"1951","journal-title":"Psychometrika"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1207\/S15327752JPA8001_18","article-title":"Starting at the Beginning: An Introduction to Coefficient Alpha and Internal Consistency","volume":"80","author":"Streiner","year":"2003","journal-title":"J. Personal. Assess."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1037\/1099-9809.12.2.275","article-title":"Exploring the Association between Color-Blind Racial Ideology and Multicultural Counseling Competencies","volume":"12","author":"Neville","year":"2006","journal-title":"Cult. Divers. Ethn. Minor. Psychol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101673","DOI":"10.1016\/j.pmedr.2021.101673","article-title":"Multilevel Determinants of COVID-19 Vaccination Hesitancy in the United States: A Rapid Systematic Review","volume":"25","author":"Wang","year":"2021","journal-title":"Prev. Med. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"6614","DOI":"10.1016\/j.vaccine.2021.09.074","article-title":"Christian Nationalism and COVID-19 Vaccine Hesitancy and Uptake","volume":"39","author":"Corcoran","year":"2021","journal-title":"Vaccine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1177\/1536867X1201200209","article-title":"Using the Margins Command to Estimate and Interpret Adjusted Predictions and Marginal Effects","volume":"12","author":"Williams","year":"2012","journal-title":"Stata J."},{"key":"ref_26","unstructured":"Dennis, J.M. (2019). AmeriSpeak Omnibus Field Report 2019, NORC at the University of Chicago."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Bethlehem, J., Cobben, F., and Schouten, B. (2011). The Use of Response Propensities. Handbook of Nonresponse in Household Surveys, John Wiley & Sons, Inc.","DOI":"10.1002\/9780470891056"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1080\/10826084.2021.1949611","article-title":"Social Stigma toward Persons with Opioid Use Disorder: Results from a Nationally Representative Survey of U.S. Adults","volume":"56","author":"Taylor","year":"2021","journal-title":"Subst. Use Misuse"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"433","DOI":"10.5993\/AJHB.25.5.1","article-title":"Perceived Realism and Role Attractiveness in Movie Portrayals of Alcohol Drinking","volume":"25","author":"Bahk","year":"2001","journal-title":"Am. J. Health Behav."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1111\/acer.12640","article-title":"Portrayal of Alcohol Intoxication on YouTube","volume":"39","author":"Primack","year":"2015","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Avery, J.D., and Avery, J.J. (2019). The Stigma of Addiction: An Essential Guide, Springer International Publishing.","DOI":"10.1007\/978-3-030-02580-9"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1057\/s41599-021-00900-z","article-title":"News Media Coverage of COVID-19 Public Health and Policy Information","volume":"8","author":"Mach","year":"2021","journal-title":"Humanit. Soc. Sci. Commun."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1093\/poq\/nfn063","article-title":"Social Desirability Bias in CATI, IVR, and Web Surveys: The Effects of Mode and Question Sensitivity","volume":"72","author":"Kreuter","year":"2008","journal-title":"Public Opin. Q."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1002\/ejsp.2420150303","article-title":"Methods of Coping with Social Desirability Bias: A Review","volume":"15","author":"Nederhof","year":"1985","journal-title":"Eur. J. Soc. Psychol."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/7\/1194\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:05:11Z","timestamp":1760126711000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/7\/1194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,3]]},"references-count":34,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["vaccines11071194"],"URL":"https:\/\/doi.org\/10.3390\/vaccines11071194","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,3]]}}}