Missed Opportunity: The Unseen Driver for Low Coronavirus Disease 2019 Vaccination Rates in Underserved Patients

Abstract

Background Vaccines against SARS-CoV-2 virus have been available since December 2020. Vaccination rates amongst hospitalized patients at our institution remained low at about 40%, thus we sought to understand the drivers of vaccine hesitancy in our patient population. Methods All unvaccinated adult patients admitted to our hospital were asked to participate in a survey to assess COVID-19 vaccine hesitancy. Updated vaccination status was collected at the end of the study. Results 97 patients agreed to participate, of which 34% were SARS-CoV-2 positive on polymerase chain reaction (PCR) testing. Of the 64 participants eligible to receive the vaccine, 57.8% were agreeable but only 27% received the vaccine before discharge. Conclusion Many patients are willing to receive the vaccine and hospitalization provides a unique opportunity to interact with patients who have been otherwise unaware, unable, or unwilling to pursue vaccination outside of the hospital.

COVID-19 Vaccine Acceptance, Attitude and Perception among Slum and Underserved Communities: A Systematic Review and Meta-Analysis

“…On further screening, 42 articles remained for eligibility assessment after excluding those which were not original studies and not done in slum/underserved communities. The final assessment yielded 24 articles for further analysis [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ].…”

“…Seventeen (17) studies reported on the factors associated with COVID-19 vaccination (acceptance/hesitancy and uptake), Table 5 . Older age was a strong predictor reported in nine studies, with some reporting a positive association with acceptance and uptake [ 28 , 30 , 35 , 38 , 41 , 42 , 47 ] and a negative association in others [ 27 , 29 ]. High education level and good health literacy were also positive correlates of vaccine acceptance and uptake [ 25 , 29 , 37 , 39 , 42 ], though some studies reported a negative association [ 32 , 38 ].…”

“…Male gender had a positive association with vaccine acceptance in five studies [ 25 , 29 , 33 , 35 , 38 ]. Ethnicity/race was a strong predictor in the USA and reported in five studies, with more vaccine hesitancy among ethnic minorities, mostly among Blacks and Hispanics [ 25 , 33 , 35 , 45 , 47 ]. Ethnicity/tribe was also a strong predictor in Uganda [ 41 ].…”

“…Nine (9) studies reported on possible reasons for COVID-19 vaccine hesitancy among slum and underserved communities ( Table 5 ). Concerns about vaccine safety, possible side effects and efficacy/effectiveness of vaccines were the most reported reasons (eight studies) for not getting vaccinated [ 29 , 30 , 31 , 32 , 33 , 36 , 46 , 47 ]. The low-risk perception was also a common reason reported in three studies [ 27 , 30 , 32 ], same as negative beliefs, attitudes and misconceptions about COVID-19 vaccines [ 27 , 32 , 46 ].…”

“…The low-risk perception was also a common reason reported in three studies [ 27 , 30 , 32 ], same as negative beliefs, attitudes and misconceptions about COVID-19 vaccines [ 27 , 32 , 46 ]. In addition, long distances to vaccination centres, inability to spare a day from work and missed opportunity [ 36 , 47 ], limited information on vaccination [ 32 , 46 ], and mistrust of healthcare workers, government and manufacturers [ 33 , 46 , 47 ] were also reported reasons for hesitancy.…”