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Yu N, Punatar N, Shaikh U, Agrawal G. Can hospitalists improve COVID-19 vaccination rates? BMJ Open Qual 2024; 13:e002646. [PMID: 38649197 PMCID: PMC11043723 DOI: 10.1136/bmjoq-2023-002646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/13/2024] [Indexed: 04/25/2024] Open
Abstract
Three years after the start of the SARS-CoV-2 virus (COVID-19) pandemic, its effects continue to affect society and COVID-19 vaccination campaigns continue to be a topic of controversy and inconsistent practice. After experiencing spikes in COVID-19 cases, our University of California Davis Health Division of Hospital Medicine sought to understand the reasons underlying the low COVID-19 vaccination rates in our county and find approaches to improve the number of vaccinations among adults admitted to the inpatient setting. This quality improvement project aimed to increase COVID-19 primary and booster vaccine efforts through a multi-pronged approach of increased collaboration with specialised staff and optimisation of use of our electronic health record system.Our key interventions focused on developing a visual reminder of COVID-19 vaccine status using the functionality of our electronic medical record (EMR), standardising documentation of COVID-19 vaccine status and enhancing team-based vaccination discussions through team huddles and partnering with inpatient care coordinators. While our grassroots approach enhanced COVID-19 vaccination rates in the inpatient setting and had additional benefits such as increased collaboration among teams, system-level efforts often made a greater impact at our healthcare centre. For other institutions interested in increasing COVID-19 vaccination rates, our top three recommendations include integrating vaccination into pre-existing workflows, optimising EMR functionality and increasing vaccine accessibility in the inpatient setting.
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Affiliation(s)
- Nina Yu
- University of California Davis Health, Sacramento, CA, USA
| | - Nisha Punatar
- University of California Davis Health, Sacramento, CA, USA
| | - Ulfat Shaikh
- University of California Davis Health, Sacramento, CA, USA
| | - Garima Agrawal
- University of California Davis Health System, Sacramento, California, USA
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Biezen R, Kaufman J, Hoq M, Manski-Nankervis JA, Sanci L, Bell JS, Leask J, Seale H, Munro J, Suryawijaya Ong D, Oliver J, Jos C, Tuckerman J, Bagot K, Danchin M. Factors impacting COVID-19 vaccine decision making in older adults and people with underlying conditions in Victoria, Australia: A cross-sectional survey. Hum Vaccin Immunother 2022; 18:2147770. [PMID: 36573307 PMCID: PMC9891679 DOI: 10.1080/21645515.2022.2147770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Australia's COVID-19 vaccine rollout included prioritizing older adults and those with underlying conditions. However, little was known around the factors impacting their decision to accept the vaccine. This study aimed to assess vaccine intentions, information needs, and preferences of people prioritized to receive the COVID-19 vaccine at the start of the Australian vaccine rollout. A cross-sectional online survey of people aged ≥70 years or 18-69 with chronic or underlying conditions was conducted between 12 February and 26 March 2021 in Victoria, Australia. The World Health Organization Behavioural and Social Drivers of COVID-19 vaccination framework and items informed the survey design and framing of results. Bivariate logistic regression was used to investigate the association between intention to accept a COVID-19 vaccine and demographic characteristics. In total, 1828 eligible people completed the survey. Intention to vaccinate was highest among those ≥70 years (89.6%, n = 824/920) versus those aged 18-69 years (83.8%, n = 761/908), with 91% (n = 1641/1803) of respondents agreeing that getting a COVID-19 vaccine was important to their health. Reported vaccine safety (aOR 1.4, 95% CI 1.1 to 1.8) and efficacy (aOR 1.9, 95% CI 1.5 to 2.3) were associated with intention to accept a COVID-19 vaccine. Concerns around serious illness, long-term effects, and insufficient vaccine testing were factors for not accepting a COVID-19 vaccine. Preferred communication methods included discussion with healthcare providers, with primary care providers identified as the most trusted information source. This study identified factors influencing the prioritized public's COVID-19 vaccine decision-making, including information preferences. These details can support future vaccination rollouts.
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Affiliation(s)
- Ruby Biezen
- Department of General Practice, University of Melbourne, Melbourne, Australia,CONTACT Ruby Biezen Department of General Practice, The University of Melbourne, 780 Elizabeth Street, Melbourne, Vic3004, Australia
| | - Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | | | - Lena Sanci
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - J. Simon Bell
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Julie Leask
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, Australia
| | - Holly Seale
- School of Population Health, University of New South Wales, Australia
| | - Jane Munro
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia
| | | | - Jane Oliver
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia,The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Australia
| | - Carol Jos
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Jane Tuckerman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Kathleen Bagot
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia,Department of General Medicine, The Royal Children’s Hospital, Melbourne, Australia
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Intent among Parents to Vaccinate Children before Pediatric COVID-19 Vaccine Recommendations, Minnesota and Los Angeles County, California-May-September 2021. Vaccines (Basel) 2022; 10:vaccines10091441. [PMID: 36146519 PMCID: PMC9504557 DOI: 10.3390/vaccines10091441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/26/2022] [Accepted: 08/26/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: This study assessed the associations between parent intent to have their child receive the COVID-19 vaccination, and demographic factors and various child activities, including attendance at in-person education or childcare. Methods: Persons undergoing COVID-19 testing residing in Minnesota and Los Angeles County, California with children aged <12 years completed anonymous internet-based surveys between 10 May and 6 September 2021 to assess factors associated with intention to vaccinate their child. Factors influencing the parents’ decision to have their child attend in-person school or childcare were examined. Estimated adjusted odds rations (AORs, 95% CI) were computed between parents’ intentions regarding children’s COVID-19 vaccination and participation in school and extra-curricular activities using multinomial logistic regression. Results: Compared to parents intending to vaccinate their children (n = 4686 [77.2%]), those undecided (n = 874 [14.4%]) or without intention to vaccinate (n = 508 [8.4%]) tended to be younger, non-White, less educated, and themselves not vaccinated against COVID-19. Their children more commonly participated in sports (aOR:1.51 1.17−1.95) and in-person faith or community activities (aOR:4.71 3.62−6.11). A greater proportion of parents without intention to vaccinate (52.5%) indicated that they required no more information to make their decision in comparison to undecided parents (13.2%). They further indicated that additional information regarding vaccine safety and effectiveness would influence their decision. COVID-19 mitigation measures were the most common factors influencing parents’ decision to have their child attend in-person class or childcare. Conclusions: Several demographic and socioeconomic factors are associated with parents’ decision whether to vaccinate their <12-year-old children for COVID-19. Child participation in in-person activities was associated with parents’ intentions not to vaccinate. Tailored communications may be useful to inform parents’ decisions regarding the safety and effectiveness of vaccination.
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Ford KL, West AB, Bucher A, Osborn CY. Personalized Digital Health Communications to Increase COVID-19 Vaccination in Underserved Populations: A Double Diamond Approach to Behavioral Design. Front Digit Health 2022; 4:831093. [PMID: 35493533 PMCID: PMC9051039 DOI: 10.3389/fdgth.2022.831093] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/25/2022] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 pandemic exacerbated pre-existing health disparities. People of historically underserved communities, including racial and ethnic minority groups and people with lower incomes and educational attainments, experienced disproportionate premature mortality, access to healthcare, and vaccination acceptance and adoption. At the same time, the pandemic increased reliance on digital devices, offering a unique opportunity to leverage digital communication channels to address health inequities, particularly related to COVID-19 vaccination. We offer a real-world, systematic approach to designing personalized behavior change email and text messaging interventions that address individual barriers with evidence-based behavioral science inclusive of underserved populations. Integrating design processes such as the Double Diamond model with evidence-based behavioral science intervention development offers a unique opportunity to create equitable interventions. Further, leveraging behavior change artificial intelligence (AI) capabilities allows for both personalizing and automating that personalization to address barriers to COVID-19 vaccination at scale. The result is an intervention whose broad component library meets the needs of a diverse population and whose technology can deliver the right components for each individual.
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Moore JE, Millar BC. Improving COVID-19 vaccine-related health literacy and vaccine uptake in patients: Comparison on the readability of patient information leaflets of approved COVID-19 vaccines. J Clin Pharm Ther 2021; 46:1498-1500. [PMID: 34046929 PMCID: PMC8242599 DOI: 10.1111/jcpt.13453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/18/2022]
Abstract
What is known and objective Preparation of patient‐facing materials of a complex topic, such as describing new vaccines for COVID‐19, is difficult to accomplish. This study examined the readability of patient information leaflets accompanying approved COVID‐19 vaccines. Comment Readability of patient‐facing literature by the medicines regulator in the United States and the United Kingdom describing the recently US (FDA) and UK (MHRA) COVID‐19 approved vaccines (Pfizer/BioNTech, AstraZeneca, Moderna) was assessed employing 10 metrics. Analyses showed that showed that this material had a Flesch Ease of Reading score of 53.5 and 54, respectively and a Flesch‐Kincaid reading age of between 7th and 8th Grade (12–13 year olds) and between 8th and 9th Grade (13–14 year olds), respectively. When compared to a recent study on COVID‐19 information on healthcare websites, the vaccine literature readability was favourable. What is new & conclusion Adoption of readability calculators and scrutiny of materials of their readability will help authors develop materials with improved understanding for COVID‐19 vaccine recipients, carers and family, potentially leading to improved health literacy and vaccine uptake.
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Affiliation(s)
- John E Moore
- Laboratory for Disinfection and Pathogen Elimination Studies, Northern Ireland Public Health Laboratory, Nightingale (Belfast City) Hospital, Belfast, UK.,School of Medicine, Dentistry and Biomedical Sciences, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, UK
| | - Beverley C Millar
- Laboratory for Disinfection and Pathogen Elimination Studies, Northern Ireland Public Health Laboratory, Nightingale (Belfast City) Hospital, Belfast, UK.,School of Medicine, Dentistry and Biomedical Sciences, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, UK
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