Background: People experiencing homelessness (PEH) are at high risk for COVID-19 complications and fatality, and have been prioritized for vaccination in many areas . Yet little is known about vaccine acceptance in this population . The objective of this study was to determine the level of vaccine hesitancy among PEH in Los Angeles, CA and to understand the covariates of hesitancy in relation to COVID-19 risk, threat perception, self-protection and information sources . Methods and findings: A novel mobile survey platform was deployed to recruit PEH from a federally qualified health center (FQHC) in Los Angeles to participate in a monthly rapid response study of COVID-19 attitudes, behaviors, and risks . Of 90 PEH surveyed , 43 (48 %) expressed some level of vaccine hesitancy based either on actual vaccine offers (17/90 = 19 %) or a hypothetical offer (73/90 = 81 %). In bivariate analysis, those with high COVID-19 threat perception were less likely to be vaccine hesitant (OR=0.34, P=.03), while those who frequently practiced COVID-19 protective behaviors were more likely to be vaccine hesitant (OR=2.21, P=.08). In a multivariate model, those with high threat perception (OR=0.25, P=.02) were less likely to be hesitant, while those engaging in COVID-19 protective behaviors were more hesitant (OR=3.63, P=.02). Those who trusted official sources were less hesitant (OR=0.37, P=.08) while those who trusted friends and family for COVID-19 information (OR=2.70, P=.07) were more likely to be hesitant .
Conclusions: Findings suggest that targeted educational and social influence interventions are needed to address high levels of vaccine hesitancy among PEH.