Suboptimal COVID‐19 vaccine uptake among hospitalised patients: an opportunity to improve vulnerable, hard‐to‐reach population vaccine rates

Abstract

Background COVID‐19 vaccination represents a key preventative part of the Australian public health approach to the SARS‐CoV‐2 pandemic. Hospital inpatients are frequently high‐risk for severe COVID‐19 and death. Anecdotes of high‐risk inpatients being unvaccinated and a lack of EMR visibility of COVID‐19 vaccination status prompted this study as these patients could represent a risk to themselves, staff, other patients and service provision. Aims To determine the uptake of COVID‐19 vaccine among inpatients at an adult Australian tertiary public hospital and identify reasons for non‐vaccination. Methods A point‐prevalence study of patient‐reported COVID‐19 vaccine status was conducted on 26 th October 2021 via an in‐person interview with collection of demographic factors and reasons for non‐vaccination. Results Of 368 (68% of inpatients) participants, 280 (76%) reported receiving at least 1 COVID‐19 vaccine dose. Vaccination status was associated with older age, having received the flu vaccine, being born in Australia and not requiring an English‐language interpreter. The majority (88%) of participants had at least 1 co‐morbid risk factor for severe COVID‐19. Of the unvaccinated (n=88), 67% were willing to be vaccinated with 54% of those indicating vaccination in hospital would be helpful and 42% requesting approval from their doctor. Conclusions Vaccine uptake in our cohort is sub‐optimal. Existing public health programs have failed to reach this high‐risk, vulnerable population. Changes to the national vaccination strategy to include a parallel in‐hospital program for all hospital encounters and target culturally and linguistically diverse individuals may improve uptake among this high‐risk, hard to reach group of patients. This article is protected by copyright. All rights reserved.

The unique COVID‐19 experience in Western Australia: lessons learnt

“…In that study, more than half would have been amenable to vaccination provided opportunistically while a hospital inpatient. 13 Patients who identified as ATSI were overrepresented in those admitted with COVID-19 and had a low rate of being up-to-date with vaccination. A report from rural Victoria identified contributors to low vaccination rates including geographical isolation, lack of engagement in health care models and lower overall health literacy.…”

“…A recent South Australian study examining the reasons for suboptimal COVID‐19 vaccine uptake among their tertiary hospital inpatients suggested that difficulty in accessing COVID‐19 vaccination and concern regarding adverse effects were barriers to vaccination, while a recommendation from their doctor was likely to increase their likelihood of vaccination. In that study, more than half would have been amenable to vaccination provided opportunistically while a hospital inpatient 13 …”

Suboptimal COVID‐19 vaccine uptake among hospitalised patients

“…Existing public health programmes have failed to reach this high‐risk vulnerable population, … (use of) hospital encounters and target(ing) culturally and linguistically diverse individuals may improve uptake among this high‐risk, hard to reach group of patients’. 1 We agree that the suboptimal COVID‐19 vaccine uptake is a common problem and it exists worldwide.…”

An Electronic Health Record Alert for Inpatient Coronavirus Disease 2019 Vaccinations Increases Vaccination Ordering and Uncovers Workflow Inefficiencies

“…Furthermore, a recent point-prevalence study revealed a strong desire amongst hospitalized patients for COVID-19 vaccination resources. 7 For these reasons, eligible inpatient encounters without successful COVID-19 vaccination represent missed opportunities for vaccination (MOV) as defined by the World Health Organization. 8 As a comparison, influenza and pneumococcal vaccination rates in the inpatient setting have been shown to be as high as 67.0% on average.…”