Best Practices for an Equitable Covid-19 Vaccination Program

Beste, Lauren A; Chen, Anders; GeyerJohn,; WilsonMaureen,; SchuttnerLinnaea,; WheatChelle,; RojasJorge,; NelsonKarin,; ReddyAshok,

doi:10.1056/cat.21.0238

Cited by 13 publications

(13 citation statements)

References 12 publications

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“…Identifying and addressing internal conflicts (by using motivational interviewing), social network interventions (making clinician recommendations build on interpersonal trust), and direct behavior change interventions (including reminders and primes, automatic appointments, and presumptive healthcare professional communication) can be helpful in this regard ( 141 ). Developing an intentional vaccine delivery strategy in conjunction with experts, utilizing multiple communication channels, and expanding vaccine delivery outside of the hospital to reach patients can be another strategy ( 142 ). Finally, the involvement of peers, family, or volunteers to support people with SMI in making healthcare choices may also be helpful.…”

Section: Discussionmentioning

confidence: 99%

COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review

et al. 2022

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Background: Increasing clinical evidence suggests that people with severe mental illness (SMI), including schizophrenia spectrum disorders, bipolar disorder (BD), and major depressive disorder (MDD), are at higher risk of dying from COVID-19. Several systematic reviews examining the association between psychiatric disorders and COVID-19-related mortality have recently been published. Although these reviews have been conducted thoroughly, certain methodological limitations may hinder the accuracy of their research findings.Methods: A systematic literature search, using the PubMed, Embase, Web of Science, and Scopus databases (from inception to July 23, 2021), was conducted for observational studies assessing the risk of death associated with COVID-19 infection in adult patients with pre-existing schizophrenia spectrum disorders, BD, or MDD. Methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).Results: Of 1,446 records screened, 13 articles investigating the rates of death in patients with pre-existing SMI were included in this systematic review. Quality assessment scores of the included studies ranged from moderate to high. Most results seem to indicate that patients with SMI, particularly patients with schizophrenia spectrum disorders, are at significantly higher risk of COVID-19-related mortality, as compared to patients without SMI. However, the extent of the variation in COVID-19-related mortality rates between studies including people with schizophrenia spectrum disorders was large because of a low level of precision of the estimated mortality outcome(s) in certain studies. Most studies on MDD and BD did not include specific information on the mood state or disease severity of patients. Due to a lack of data, it remains unknown to what extent patients with BD are at increased risk of COVID-19-related mortality. A variety of factors are likely to contribute to the increased mortality risk of COVID-19 in these patients. These include male sex, older age, somatic comorbidities (particularly cardiovascular diseases), as well as disease-specific characteristics.Conclusion: Methodological limitations hamper the accuracy of COVID-19-related mortality estimates for the main categories of SMIs. Nevertheless, evidence suggests that SMI is associated with excess COVID-19 mortality. Policy makers therefore must consider these vulnerable individuals as a high-risk group that should be given particular attention. This means that targeted interventions to maximize vaccination uptake among these patients are required to address the higher burden of COVID-19 infection in this already disadvantaged group.

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Section: Discussionmentioning

confidence: 99%

COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review

et al. 2022

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“…Special considerations are required to provide equal access to COVID-19 vaccinations for homebound older persons and people with mobility difficulties living in rural regions to reduce barriers to vaccine access. Although costly, it is imperative that mobile vaccination clinics and in-home vaccination programs be made available to the homebound rural population ( Beste et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccination Experiences of Family Caregivers of Persons Living with Dementia in Rural Appalachia

et al. 2022

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The study investigated COVID-19 vaccine acceptance, hesitancy, and barriers among family caregivers of rural community-dwelling persons living with dementia (PLwD). Three waves of telephone interviews with 26 family caregivers (96% White, 81% Female, Mage = 63 ± 12 years) were analyzed using thematic content analysis. At Wave 3, although all dyads were eligible, only 10 dyads had received their first dose of the vaccine. In 10 dyads, neither person had received the vaccine; in2 dyads, the caregivers did but the PLwD did not; and in 4 dyads, the caregiver did not but the PLwD did. Perceived direct and indirect health risks, cues from trusted allies, and ability to overcome vaccination barriers affected COVID-19 vaccination acceptance. Vaccine refusals were motivated by a low perceived risk of COVID-19, vaccine fear, and personal beliefs. Findings have implications for administration of preventative care practices for dementia family caregivers living in remote locations during a public health emergency.

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“…Additionally, the transparency of government authorities and agencies, research experts, and health care professionals is necessary to educate the public about the safety and side-effects of vaccines versus the risk of C19. Indeed, a system to report potential side-effects and other issues concerning immunization will help people to make informed decisions about the risk versus reward of vaccination [ 49 , 50 ]. While these continue to be issues two years into the pandemic, there are other needs in health care that must adapt to manage future outbreaks.…”

Section: Introductionmentioning

confidence: 99%

Global Challenges to Public Health Care Systems during the COVID-19 Pandemic: A Review of Pandemic Measures and Problems

Filip

Puscaselu

Anchidin-Norocel

et al. 2022

JPM

266

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Beginning in December 2019, the world faced a critical new public health stressor with the emergence of SARS-CoV-2. Its spread was extraordinarily rapid, and in a matter of weeks countries across the world were affected, notably in their ability to manage health care needs. While many sectors of public structures were impacted by the pandemic, it particularly highlighted shortcomings in medical care infrastructures around the world that underscored the need to reorganize medical systems, as they were vastly unprepared and ill-equipped to manage a pandemic and simultaneously provide general and specialized medical care. This paper presents modalities in approaches to the pandemic by various countries, and the triaged reorganization of medical sections not considered first-line in the pandemic that was in many cases transformed into wards for treating COVID-19 cases. As new viruses and structural variants emerge, it is important to find solutions to streamline medical care in hospitals, which includes the expansion of digital network medicine (i.e., telemedicine and mobile health apps) for patients to continue to receive appropriate care without risking exposure to contagions. Mobile health app development continues to evolve with specialized diagnostics capabilities via external attachments that can provide rapid information sharing between patients and care providers while eliminating the need for office visits. Telemedicine, still in the early stages of adoption, especially in the developing world, can ensure access to medical information and contact with care providers, with the potential to release emergency rooms from excessive cases, and offer multidisciplinary access for patients and care providers that can also be a means to avoid contact during a pandemic. As this pandemic illustrated, an overhaul to streamline health care is essential, and a move towards greater use of mobile health and telemedicine will greatly benefit public health to control the spread of new variants and future outbreaks.

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Best Practices for an Equitable Covid-19 Vaccination Program

Abstract: Leaders at the VA Puget Sound Health Care System vaccinated Black, Hispanic, and multiracial patients at rates exceeding population averages through outreach efforts that are accessible to other health care organizations.

Cited by 13 publications

References 12 publications

COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review

COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review

COVID-19 Vaccination Experiences of Family Caregivers of Persons Living with Dementia in Rural Appalachia

Global Challenges to Public Health Care Systems during the COVID-19 Pandemic: A Review of Pandemic Measures and Problems

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