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Abstract
Abstract
Background
Widespread vaccination is an essential component of the public health response to
the COVID‐19 pandemic, yet vaccine hesitancy remains pervasive. This prospective survey
investigation aimed to measure the prevalence of vaccine hesitancy in a patient cohort
at two urban Emergency Departments (EDs) and characterize underlying factors contributing
to hesitancy.
Methods
Adult ED patients with stable clinical status (Emergency Severity Index 3‐5) and without
active COVID‐19 disease or altered mental status were considered for participation.
Demographic elements were collected, as well as reported barriers/concerns related
to vaccination and trusted sources of health information. Data were collected in‐person
via a survey instrument proctored by trained research assistants.
Results
1,555 patients were approached, and 1,068 patients completed surveys (completion rate
68.7%). Mean age was 44.1 y (SD 15.5, range 18‐93), 61% were female, and 70% were
Black. 31.6% of ED patients reported vaccine hesitancy. Of note, 19.7% of the hesitant
cohort were healthcare workers. In multivariable regression analysis, Black race (OR
4.24, 95%CI 2.62‐6.85) and younger age (age 18‐24 y, OR 4.57, 95%CI 2.66‐7.86; age
25‐35 y, OR 5.71, 95% CI 3.71‐8.81) were independently associated with hesitancy,
to a greater degree than level of education (high school education or less, OR 2.27,
95%CI 1.23‐4.19). Hesitant patients were significantly less likely to trust governmental
sources of vaccine information than non‐hesitant patients (39.6% vs 78.9%, p<0.001);
less difference was noted in the domain of trust towards friends/family (51.1% vs.
61.0%, p=0.004). Hesitant patients also reported perceived vaccine safety concerns
and perceived insufficient research.
Conclusions
Vaccine hesitancy is common among ED patients, and more common among Black and younger
patients, independent of education level. Hesitant patients report perceived safety
concerns and low trust in government information sources, but less so friends or family.
This suggests strategies to combat hesitancy may need tailoring to specific populations.