Robert M Rodriguez1, Jesus R Torres2, Anna Marie Chang3, Adrianne N Haggins4, Stephanie A Eucker5, Kelli N O'Laughlin6, Erik Anderson7, Daniel G Miller8, R Gentry Wilkerson9, Martina Caldwell10, Stephen C Lim11, Ali S Raja12, Brigitte M Baumann13, Joseph Graterol14, Vidya Eswaran14, Brian Chinnock15. 1. Department of Emergency Medicine, University of California San Francisco, San Francisco, CA. Electronic address: robert.rodriguez@ucsf.edu. 2. Department of Emergency Medicine, Olive View UCLA Medical Center-University of California Los Angeles School of Medicine, Los Angeles, CA. 3. Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA. 4. Department of Emergency Medicine, University of Michigan, Ann Arbor, MI. 5. Division of Emergency Medicine, Department of Surgery, Duke University, Durham, NC. 6. Departments of Emergency Medicine and Global Health, University of Washington, Seattle, WA. 7. Department of Emergency Medicine, Highland Hospital-Alameda Health System, Oakland, CA. 8. Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA. 9. Department of Emergency Medicine, University of Maryland School of Medicine, College Park, MD. 10. Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI. 11. Section of Emergency Medicine, University Medical Center New Orleans, Louisiana State University Health Sciences Center, New Orleans, LA. 12. Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA. 13. Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ. 14. Department of Emergency Medicine, University of California San Francisco, San Francisco, CA. 15. Department of Emergency Medicine, University of California San Francisco Fresno, Fresno, CA.
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.
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.
Authors: Felix E Fernández-Penny; Eliana L Jolkovsky; Frances S Shofer; Keith C Hemmert; Hisham Valiuddin; Julie E Uspal; Nathaniel A Sands; Benjamin S Abella Journal: Acad Emerg Med Date: 2021-10-04 Impact factor: 5.221
Authors: Robert M Rodriguez; Kelli O'Laughlin; Stephanie A Eucker; Anna Marie Chang; Kristin L Rising; Graham Nichol; Alena Pauley; Hemal Kanzaria; Alexzandra T Gentsch; Cindy Li; Herbie Duber; Jonathan Butler; Vidya Eswaran; Dave Glidden Journal: Trials Date: 2022-04-21 Impact factor: 2.728
Authors: Michael J Waxman; Maile Ray; Elissa M Schechter-Perkins; Kiran Faryar; Karen Coen Flynn; Mandi Breen; Susan M Wojcik; Fiona Berry; Amy Zheng; Ashar Ata; E Brooke Lerner; Michael S Lyons; Sandra McGinnis Journal: Public Health Rep Date: 2022-04-23 Impact factor: 3.117
Authors: Robert Rodriguez; Kelli O'Laughlin; Stephanie Eucker; Anna Marie Chang; Kristin Rising; Graham Nichol; Alena Pauley; Hemal Kanzaria; Alexzandra Gentsch; Cindy Li; Herbie Duber; Jonathan Butler; Vidya Eswaran; Dave Glidden Journal: Res Sq Date: 2022-03-17
Authors: Vidya Eswaran; Anna Marie Chang; R Gentry Wilkerson; Kelli N O'Laughlin; Brian Chinnock; Stephanie A Eucker; Brigitte M Baumann; Nancy Anaya; Daniel G Miller; Adrianne N Haggins; Jesus R Torres; Erik S Anderson; Stephen C Lim; Martina T Caldwell; Ali S Raja; Robert M Rodriguez Journal: PLoS One Date: 2022-04-13 Impact factor: 3.240
Authors: Salimah Z Shariff; Lucie Richard; Stephen W Hwang; Jeffrey C Kwong; Cheryl Forchuk; Naheed Dosani; Richard Booth Journal: Lancet Public Health Date: 2022-03-09