Reaching the hard to reach: Characteristics of patients who received a COVID‐19 vaccine in the emergency department

Heinert, Sara; McCoy, James David; Eisenstein, Robert; Rowley, Jessica

doi:10.1111/acem.14334

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…One study of ED and nursing department heads in French EDs demonstrated that perceived factors limiting the ability of EDs to vaccinate patients against COVID-19 included overcrowding, a lack of medical staff, and a lack of patient follow-up [ 35 ]. Other studies have shown that CV programs are feasible and can increase the vaccination of vulnerable groups in adult populations in both the US and Australia [ 52 , 53 ]. We expand on this literature by assessing the practical experiences of pediatric EDs related to CV programs for children in the US.…”

Section: Discussionmentioning

confidence: 99%

Emergency Departments: An Underutilized Resource for Expanding COVID-19 Vaccine Coverage in Children

Hart,

Feygin,

Kluthe

et al. 2023

Vaccines

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COVID-19 vaccine (CV) acceptance rates remain suboptimal in children. Emergency departments (EDs) represent a unique opportunity to improve vaccination rates, particularly in underserved children. Little is known about the presence or reach of CV programs in US EDs. We assessed, via a cross-sectional survey of pediatric ED physicians, the number of EDs offering CVs to children, the approximate numbers of vaccines administered annually, and the perceived facilitators/barriers to vaccination. The proportion of EDs offering CVs is reported. Chi-square tests compared facilitators and barriers among frequent vaccinators (≥50 CVs/year), infrequent vaccinators (<50 CVs/year), and non-vaccinators. Among 492 physicians from 166 EDs, 142 responded (representing 61 (37.3%) EDs). Most EDs were in large, urban, academic, freestanding children’s hospitals. Only 11 EDs (18.0%) offer ≥1 CV/year, and only two (18.2%) of these gave ≥50 CVs. Common facilitators of vaccination included the electronic health record facilitation of vaccination, a strong provider/staff buy-in, storage/accessibility, and having a leadership team or champion. Barriers included patient/caregiver refusal, forgetting to offer vaccines, and, less commonly, a lack of buy-in/support and the inaccessibility of vaccines. Many (28/47, 59.6%) EDs expressed interest in establishing a CV program.

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Section: Discussionmentioning

confidence: 99%

Emergency Departments: An Underutilized Resource for Expanding COVID-19 Vaccine Coverage in Children

Hart,

Feygin,

Kluthe

et al. 2023

Vaccines

View full text Add to dashboard Cite

show abstract

“…9 Studies suggest that ED-based COVID-19 vaccine interventions may be a way to reach these vulnerable populations, similar to other public health interventions (eg, HIV testing and influenza vaccination). [9][10][11] The purpose of this quality improvement (QI) pilot study was to improve vaccine uptake among patients offered COVID-19 vaccination in the ED. While it can be difficult for the care team to have thoughtful conversations with vaccinehesitant patients due to time constraints, other resources such as students 12,13 may be available.…”

Section: Introductionmentioning

confidence: 99%

Vaccine Acceptance During a Novel Student-led Emergency Department COVID-19 Vaccination Program

Eastin¹,

Moore²,

Moulton³

et al. 2023

WestJEM

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Introduction The coronavirus 2019 (COVID-19) pandemic not only exacerbated barriers to healthcare but has also highlighted the trend toward increased vaccine hesitancy. Our goal was to improve COVID-19 vaccine uptake through a student-led, emergency department-based (ED) vaccination program. Methods This prospective, quality-improvement pilot program used medical and pharmacy student volunteers as COVID-19 vaccine screeners in a southern, urban, academic ED. Patients eligible for vaccination were offered either the Janssen-Johnson & Johnson or the Pfizer-BioNTech COVID-19 vaccine and were educated about vaccine concerns. Vaccine acceptance rates were recorded, as well as reasons for vaccine hesitancy, vaccine brand preferences, and demographics. The primary and secondary quantitative outcomes were overall vaccine acceptance and change in vaccine acceptance after student-provided education, respectively. We performed logistic regression to identify potential variables that correlated with vaccine acceptance. Guided by the Consolidated Framework for Implementation Research, focus group interviews with four key stakeholder groups explored implementation facilitators and barriers. Results We screened 406 patients for COVID-19 vaccination eligibility and current vaccine status, the majority of whom were unvaccinated. Of unvaccinated or partially vaccinated patients, vaccine acceptance before education was 28.3% (81/286), and vaccine acceptance after education was 31.5% (90/286) (% difference, 3.1% [95% CI 0.3%–5.9%], P=0.03). The most common hesitancy factors cited were concerns about side effects and safety. Results from the regression analysis indicated that increasing age and Black race were associated with an increased odds of vaccine acceptance. Focus groups revealed implementation barriers, including patient resistance and workflow issues, and facilitators, including student involvement and public health promotion. Conclusion Using medical and pharmacy student volunteers as COVID-19 vaccine screeners was successful, and brief education provided by the students led to a modest increase in vaccine acceptance, with overall acceptance of 31.5%. Numerous educational benefits are described.

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“… 10 , 11 One other observational study reported on a successful experience delivering vaccinations to populations at disproportionate risk of poor outcomes from COVID-19 in an ED. 12 Despite these initial encouraging reports, gaps in knowledge remain in understanding ED patients’ perspectives and willingness to accept vaccination according to their prior degree of vaccine hesitancy and in elucidating the optimal messaging to offer vaccinations in clinical settings.…”

mentioning

confidence: 99%

Patients’ Perspectives on Emergency Department COVID-19 Vaccination and Vaccination Messaging Through Randomized Vignettes

et al. 2022

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Objectives: Emergency departments (EDs) could play an important role in the COVID-19 pandemic response by reaching patients who would otherwise not seek vaccination in the community. Prior to expanding COVID-19 vaccination to the acute care setting, we assessed ED patients’ COVID-19 vaccine status, perspectives, and hypothetical receptivity to ED-based vaccination. Methods: From January 11 through March 31, 2021, we conducted a multisite (Albany Medical Center, Boston Medical Center, Buffalo General Hospital, University of Cincinnati Medical Center, and Upstate Medical Center), cross-sectional survey of ED patients, with embedded randomization for participants to receive 1 of 4 vignette vaccination messages (simple opt-in message, recommendation by the hospital, community-oriented message, and acknowledgment of vaccine hesitancy). Main outcomes included COVID-19 vaccination status, prior intention to be vaccinated, and receptivity to randomized hypothetical vignette messages. Results: Of 610 participants, 122 (20.0%) were vaccinated, 234 (38.4%) had prior intent to be vaccinated, 111 (18.2%) were unsure as to prior intent, and 143 (23.4%) had no prior intent to be vaccinated. Vaccine hesitancy (participants who were vaccine unsure or did not intend to receive the vaccine) was associated with the following: age <45 years, female, non-Hispanic Black, no primary health care, and no prior influenza vaccination. Overall, 364 of 565 (64.4%; 95% CI, 60.3%-68.4%) were willing to accept a hypothetical vaccination in the ED. Among participants with prior vaccine hesitancy, a simple opt-in message resulted in the highest acceptance rates to hypothetical vaccination (39.7%; 95% CI, 27.6%-52.8%). Conclusions: EDs have appropriate patient populations to initiate COVID-19 vaccination programs as a supplement to community efforts. A simple opt-in approach may offer the best messaging to reach vaccine-hesitant ED patients.

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Reaching the hard to reach: Characteristics of patients who received a COVID‐19 vaccine in the emergency department

Cited by 4 publications

References 3 publications

Emergency Departments: An Underutilized Resource for Expanding COVID-19 Vaccine Coverage in Children

Emergency Departments: An Underutilized Resource for Expanding COVID-19 Vaccine Coverage in Children

Vaccine Acceptance During a Novel Student-led Emergency Department COVID-19 Vaccination Program

Patients’ Perspectives on Emergency Department COVID-19 Vaccination and Vaccination Messaging Through Randomized Vignettes

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