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Parameswaran L, Jaysing A, Ding H, Wilkenfeld M, Dean R, Wilson KK, Frank O, Duerr R, Mulligan MJ. Vaccine Equity: Lessons Learned Exploring Facilitators and Barriers to COVID-19 Vaccination in Urban Black Communities. J Racial Ethn Health Disparities 2024; 11:2109-2119. [PMID: 37391605 DOI: 10.1007/s40615-023-01680-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 07/02/2023]
Abstract
COVID-19 vaccines were developed at unparalleled speed, but racial disparities persist in vaccine uptake. This is a cross-sectional survey that was conducted in mid-2021 in ambulatory clinics across Brooklyn, New York. The objectives of the study were to assess: knowledge of COVID-19, healthcare communication and access, attitudes including trust in the process of vaccine development and mistrust due to racial discrimination, and to determine the relationship of the above to vaccine receipt. 58 respondents self-identified as Black non-Hispanic and completed the survey: the majority were women (79%), <50 years old (65%), employed (66%), and had annual household income <$75,000 (59%). The majority reported having some health insurance (97%) and a regular place of healthcare (95%). 60% of respondents reported COVID-19 vaccination receipt. A significant percentage of the vaccinated group compared to the unvaccinated group scored higher on knowledge questions (91% vs. 65%; p = 0.018), felt it was important that others in the community get vaccinated (89% vs. 65%, p = 0.04), and trusted vaccine safety (86% vs. 35%; p < 0.0001) and effectiveness (88% vs. 48%; p < 0.001). The unvaccinated group reported a lower annual household income of <$75,000 (72% vs. 50%; p = 0.0002) and also differed by employment status (p = 0.04). Majority in both groups agreed that racial discrimination interferes with healthcare (78%). In summary, unvaccinated Black non-Hispanic respondents report significant concerns about vaccine safety and efficacy and have greater mistrust in the vaccine development process. The relationship between racial discrimination, mistrust, and vaccine hesitancy needs further study in order to improve vaccine uptake in this population.
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Affiliation(s)
- Lalitha Parameswaran
- New York University (NYU) Langone Vaccine Center, New York, NY, USA.
- Division of Infectious Diseases and Immunology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA.
| | - Anna Jaysing
- NYU Long Island School of Medicine, New York, NY, USA
| | - Helen Ding
- NYU Long Island School of Medicine, New York, NY, USA
| | - Marc Wilkenfeld
- Division of Occupational/Environmental Medicine, Department of Medicine, NYU Long Island School of Medicine, New York, NY, USA
| | - Ranekka Dean
- Division of Infectious Diseases and Immunology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Kesi K Wilson
- New York University (NYU) Langone Vaccine Center, New York, NY, USA
- Division of Infectious Diseases and Immunology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Olivia Frank
- New York University (NYU) Langone Vaccine Center, New York, NY, USA
| | - Ralf Duerr
- New York University (NYU) Langone Vaccine Center, New York, NY, USA
- Division of Infectious Diseases and Immunology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Department of Microbiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Mark J Mulligan
- New York University (NYU) Langone Vaccine Center, New York, NY, USA
- Division of Infectious Diseases and Immunology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
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Mejia MC, Mitchell J, Dumpa M, Maki DG, DiCorcia M, Levine RS, Hennekens CH. Emerging data in COVID-19 create urgent challengers for health providers: Updates on COVID-19 vaccine and Paxlovid. J Natl Med Assoc 2024; 116:174-179. [PMID: 38218693 DOI: 10.1016/j.jnma.2024.01.007] [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: 08/30/2023] [Revised: 12/03/2023] [Accepted: 01/02/2024] [Indexed: 01/15/2024]
Abstract
In this original research we present new emerging data in COVID-19 that create urgent challenges for health providers in prevention and treatment. Health providers should be aware that COVID-19 cases, hospitalizations, and deaths have increased markedly in August 2023. Further, recent data demonstrate a new emerging strain resistant to prior natural and vaccine immunity. The most recent emerging data show that only this updated COVID-19 vaccine produces the same immune response as previous vaccines that reduced mortality by over 95 % and morbidity by over 99 %. This recommendation encompasses all adults and children aged 6 months and older, regardless of whether they have had a prior COVID-19 infection or even if they have never received a prior vaccination. This updated COVID-19 vaccine, approved in September 2023, will be the best means to prevent COVID-19 during this upcoming season of respiratory viruses. In the meanwhile, all members of the US population regardless of previous natural infection, vaccines, or boosters are equally susceptible. At present, health providers should counsel all their patients about masking, social distancing, and avoiding crowds, especially indoors where regions of extreme weather conditions are keeping people indoors in closed quarters. In the treatment of COVID-19 the major clinical challenge to health providers, especially in their Black patients, is to prescribe Paxlovid during the first 5 days after onset of symptoms and a positive test.
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Affiliation(s)
- Maria Carmenza Mejia
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Dr, Houston, 77098, TX, United States.
| | - John Mitchell
- Charles E. Schmidt College of Medicine, Florida Atlantic University, United States
| | - Meghana Dumpa
- Charles E. Schmidt College of Medicine, Florida Atlantic University, United States
| | - Dennis G Maki
- Division of Infectious Disease and Hospital Epidemiologist, University of Wisconsin School of Medicine & Public Health, United States
| | - Mark DiCorcia
- Charles E. Schmidt College of Medicine, Florida Atlantic University, United States
| | - Robert S Levine
- Baylor College of Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, United States
| | - Charles H Hennekens
- Charles E. Schmidt College of Medicine, Florida Atlantic University, United States
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Marcelin JR, Hicks LA, Evans CD, Wiley Z, Kalu IC, Abdul-Mutakabbir JC. Advancing health equity through action in antimicrobial stewardship and healthcare epidemiology. Infect Control Hosp Epidemiol 2024; 45:412-419. [PMID: 38351853 DOI: 10.1017/ice.2024.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Jasmine R Marcelin
- Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Lauri A Hicks
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher D Evans
- Healthcare-Associated Infections and Antimicrobial Resistance Program, Tennessee Department of Health, Nashville, Tennessee
| | - Zanthia Wiley
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Ibukunoluwa C Kalu
- Division of Pediatric Infectious Disease, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Jacinda C Abdul-Mutakabbir
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California
- Division of the Black Diaspora and African American Studies, University of California San Diego, La Jolla, California
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McCabe CA, Venkatram C, Yarakala S, Korin M, Boulos A, Oliver K. Assessing COVID-19 Vaccine Hesitancy and Trust in Home Health Workers in New York City: A Pilot Study. J Occup Environ Med 2024; 66:166-173. [PMID: 38037263 DOI: 10.1097/jom.0000000000003019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
OBJECTIVE This study aimed to identify characteristics surrounding COVID-19 vaccine hesitancy and trust in home health workers (HHWs) in New York City. METHODS Data were collected from HHWs through focus group sessions conducted via Zoom. We developed a facilitator guide using the 5C Scale, a validated psychometric tool for assessing vaccine hesitancy. We performed qualitative thematic analysis using a combined inductive and deductive approach. RESULTS Major themes that emerged included the following: conflicting information decreased vaccine confidence; individualized outreach is valued when information gathering; mandates and financial incentives may increase skepticism; low health literacy and conflict in personal relationships are barriers to acceptance; and experiencing a severe infection and fear of exposure at work increase acceptance. CONCLUSIONS Based on our study, personalized yet consistent messaging may be key to reaching hesitant HHWs.
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Chatterjee K, Markham Shaw C, Brannon GE, Jang CY, Christie TB, Rodriguez J, Sinta V. COVID-19 Vaccination Hesitancies: A Spanish-Language Focus Group Analysis in Texas. HEALTH COMMUNICATION 2023:1-12. [PMID: 37712138 DOI: 10.1080/10410236.2023.2258310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
COVID-19 related health disparities are prevalent among higher risk populations like the Hispanic community. Vaccination is one readily available public health tool, yet vaccine uptake is lower among minority populations and hesitations and concerns are high. In the present study, interpersonal and media sources of information about COVID-19 were discussed in a series of six focus groups with Spanish-language dominant and bilingual English-Spanish respondents in a large metropolitan area in Texas. Participants reported using legacy media as a main source of information about COVID-19 vaccines and encountered conspiracy theories and misinformation on social media. Using the Health Belief Model as the theoretical lens, we found individuals' and family members' perceived susceptibility to COVID-19 played a part in participants wanting to find and get the vaccine. Provider recommendations may have served as cues to action. Ease of receiving the vaccines at church and pharmacies may have served to boost participants self-efficacy. Perceived barriers include vaccine specific reasons such as the fast pace of initial authorization, side effects, and long-term effects along with conspiracy theories. Prevailing information gaps regarding the COVID-19 vaccines and the resulting uncertainty are discussed. Understanding information sources and the trust Hispanic communities place in these sources is important in designing effective health messages.
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Affiliation(s)
| | | | | | - Chyng-Yang Jang
- Department of Communication, University of Texas at Arlington
| | | | | | - Vinicio Sinta
- Department of Communication, University of Texas at Arlington
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