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Rodriguez RM, Torres JR, Chang AM, Haggins AN, Eucker SA, O'Laughlin KN, Anderson E, Miller DG, Wilkerson RG, Caldwell M, Lim SC, Raja AS, Baumann BM, Graterol J, Eswaran V, Chinnock B. The Rapid Evaluation of COVID-19 Vaccination in Emergency Departments for Underserved Patients Study. Ann Emerg Med 2021; 78:502-510. [PMID: 34272104 PMCID: PMC8165082 DOI: 10.1016/j.annemergmed.2021.05.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/09/2021] [Accepted: 05/24/2021] [Indexed: 12/20/2022]
Abstract
Study objective Emergency departments (EDs) often serve vulnerable populations who may lack primary care and have suffered disproportionate COVID-19 pandemic effects. Comparing patients having and lacking a regular source of medical care and other ED patient characteristics, we assessed COVID-19 vaccine hesitancy, reasons for not wanting the vaccine, perceived access to vaccine sites, and willingness to get the vaccine as part of ED care. Methods This was a cross-sectional survey conducted from December 10, 2020, to March 7, 2021, at 15 safety net US EDs. Primary outcomes were COVID-19 vaccine hesitancy, reasons for vaccine hesitancy, and sites (including EDs) for potential COVID-19 vaccine receipt. Results Of 2,575 patients approached, 2,301 (89.4%) participated. Of the 18.4% of respondents who lacked a regular source of medical care, 65% used the ED as their usual source of health care. The overall rate of vaccine hesitancy was 39%; the range among the 15 sites was 28% to 58%. Respondents who lacked a regular source of medical care were more commonly vaccine hesitant than those who had a regular source of medical care (47% versus 38%, 9% difference, 95% confidence interval 4% to 14%). Other characteristics associated with greater vaccine hesitancy were younger age, female sex, Black race, Latinx ethnicity, and not having received an influenza vaccine in the past 5 years. Of the 61% who would accept a COVID-19 vaccine, 21% stated that they lacked a primary physician or clinic at which to receive it; the vast majority (95%) of these respondents would accept the COVID-19 vaccine as part of their care in the ED. Conclusion ED patients who lack a regular source of medical care are particularly hesitant regarding COVID-19 vaccination. Most COVID-19 vaccine acceptors would accept it as part of their care in the ED. EDs may play pivotal roles in COVID-19 vaccine messaging and delivery to highly vulnerable populations.
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Affiliation(s)
- Robert M Rodriguez
- Department of Emergency Medicine, University of California San Francisco, San Francisco, CA.
| | - Jesus R Torres
- Department of Emergency Medicine, Olive View UCLA Medical Center-University of California Los Angeles School of Medicine, Los Angeles, CA
| | - Anna Marie Chang
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA
| | | | - Stephanie A Eucker
- Division of Emergency Medicine, Department of Surgery, Duke University, Durham, NC
| | - Kelli N O'Laughlin
- Departments of Emergency Medicine and Global Health, University of Washington, Seattle, WA
| | - Erik Anderson
- Department of Emergency Medicine, Highland Hospital-Alameda Health System, Oakland, CA
| | - Daniel G Miller
- Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - R Gentry Wilkerson
- Department of Emergency Medicine, University of Maryland School of Medicine, College Park, MD
| | - Martina Caldwell
- Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI
| | - Stephen C Lim
- Section of Emergency Medicine, University Medical Center New Orleans, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Ali S Raja
- Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Brigitte M Baumann
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ
| | - Joseph Graterol
- Department of Emergency Medicine, University of California San Francisco, San Francisco, CA
| | - Vidya Eswaran
- Department of Emergency Medicine, University of California San Francisco, San Francisco, CA
| | - Brian Chinnock
- Department of Emergency Medicine, University of California San Francisco Fresno, Fresno, CA
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