People who inject drugs (PWID) experience disproportionate risk of being infected with
SARS-CoV-2, the virus that causes COVID-19. Unfortunately, due to stigma, fear of
mistreatment, and other factors, PWID are far less likely to be vaccinated compared to
other populations. African American and Latino populations also face disproportionate
risk of infection and far greater COVID-19 death rates compared to White populations, yet
due to issues including longstanding medical mistrust are also far less likely to
vaccinate. For African American and Latino PWID, COVID-related risks increase even
further and vaccination becomes even more unlikely.

In response, we propose to continue our collaboration with New York Harm Reduction
Educators (NYHRE) a prominent New York City community based organization serving African
American and Latino PWID. To increase SARS-CoV-2 vaccination among our target population,
we will first assemble a community advisory board (CAB) that we will consult at all
phases of the project.

Next, we will recruit a separate sample of PWID (n=500) via respondent driven sampling to
evaluate intervention materials as part of a clinical trial. Upon enrollment,
participants will be offered a free vaccination against SARS-CoV-2. Those who do not
initially vaccinate will be randomized into one of two intervention groups: a no video
group, and a video text group. The no video group will receive weekly text messages
designed to address barriers to vaccination identified in formative research. The video
text group will receive the same texts, along with links to videos we develop with NYHRE
staff and clients to address barriers to SARS-CoV-2 vaccination. Our intervention will
track response rates in both groups. Primary outcome measures will be vaccination within
the initial weeks following enrollment and the subsequent intervention period by
treatment group. Additional outcomes will include vaccination rates by demographic,
including race/ethnicity and primary language (i.e. do English speaking participants
respond differently to specific intervention components compared to monolingual Spanish
speakers).

If shown successful this approach can be replicated with additional populations that
experience health disparities, and in different languages across the United States.