The Rapid Evaluation of COVID-19 Vaccination in Emergency Departments for Underserved Patients Study - 23/09/21
, Jesus R. Torres, MD, MPH b, Anna Marie Chang, MD, MSCE c, Adrianne N. Haggins, MD, MS d, Stephanie A. Eucker, MD, PhD e, Kelli N. O’Laughlin, MD, MPH f, Erik Anderson, MD g, Daniel G. Miller, MD h, R. Gentry Wilkerson, MD i, Martina Caldwell, MD, MS j, Stephen C. Lim, MD k, Ali S. Raja, MD, MPH l, Brigitte M. Baumann, MD, MSCE m, Joseph Graterol, MD a, Vidya Eswaran, MD a, Brian Chinnock, MD nThe REVVED UP Investigators
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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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| Please see page 503 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Donald M. Yealy, MD. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
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| Author contributions: RMR and JT designed the study and performed data analysis. All authors were responsible for study implementation, data acquisition, and manuscript preparation. RMR takes responsibility for the paper as a whole. |
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| All authors attest to meeting the four ICMJE.org authorship criteria:(1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (seewww.icmje.org). The authors have stated that no such relationships exist. |
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Vol 78 - N° 4
P. 502-510 - octobre 2021 Retour au numéro
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