Abstract
OBJECTIVE: To estimate risk of being unvaccinated against COVID-19 by experience of intimate partner violence (IPV). METHODS: Among 3,343 partnered individuals in a community-based U.S. cohort, we quantified emotional and physical IPV experienced between March and December 2020 and estimated risk of being unvaccinated against COVID-19 through June 2021 by experience of IPV. Experience of recent IPV was defined as endorsement of more frequent or severe IPV since the start of the pandemic or report of any past-month IPV in at least one of four follow-up surveys conducted by the end of December 2020. We created a three-level composite variable - no experience of IPV, experience of emotional but not physical IPV, and experience of physical IPV. RESULTS: Cisgender women, non-binary, or transgender individuals who reported experiencing emotional, but not physical, IPV and those who reported experiencing physical IPV were both at significantly higher risk of being unvaccinated for COVID-19 compared to those who reported experiencing no IPV (ARR(emotional violence): 1.28 [95 % CI: 1.09 - 1.51]; ARR(physical violence): 1.70 [95 % CI: 1.41 - 2.05]). Cisgender men who reported experiencing physical IPV were also at significantly higher risk of being unvaccinated for COVID-19 (ARR(physical violence): 1.52 [95 % CI: 1.15 - 2.02]). CONCLUSIONS: IPV may increase the risk of low vaccine uptake. Results highlight the need to incorporate IPV prevention and support into public health responses, with targeted resources and consideration for reducing barriers to public health interventions among those impacted.