학술논문

The Rapid Evaluation of COVID-19 Vaccination in Emergency Departments for Underserved Patients Study
Document Type
article
Source
Annals of Emergency Medicine. 78(4)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Immunization
Prevention
Emergency Care
Clinical Research
Vaccine Related
Health Services
Prevention of disease and conditions
and promotion of well-being
3.4 Vaccines
Generic health relevance
Good Health and Well Being
COVID-19
COVID-19 Vaccines
Cross-Sectional Studies
Emergency Service
Hospital
Female
Health Services Accessibility
Humans
Male
Surveys and Questionnaires
United States
Vaccination
Vaccination Refusal
Vulnerable Populations
REVVED UP Investigators
Emergency & Critical Care Medicine
Clinical sciences
Language
Abstract
Study objectiveEmergency 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.MethodsThis 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.ResultsOf 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.ConclusionED 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.