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      COVID‐19 Vaccine Hesitancy Among Patients in Two Urban Emergency Departments

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          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.

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          Author and article information

          Contributors
          benjamin.abella@pennmedicine.upenn.edu
          Journal
          Acad Emerg Med
          Acad Emerg Med
          10.1111/(ISSN)1553-2712
          ACEM
          Academic Emergency Medicine
          John Wiley and Sons Inc. (Hoboken )
          1069-6563
          1553-2712
          17 August 2021
          17 August 2021
          Affiliations
          [ 1 ] Department of Emergency Medicine University of Pennsylvania USA
          [ 2 ] Penn Acute Research Collaboration University of Pennsylvania USA
          Author notes
          [*] [* ] Corresponding author

          Benjamin S. Abella, MD MPhil FACEP, Department of Emergency Medicine, 3400 Spruce Street Ground Ravdin, Philadelphia, PA 19104

          Email: benjamin.abella@ 123456pennmedicine.upenn.edu

          Article
          ACEM14376
          10.1111/acem.14376
          8441923
          34403539
          1f7881b7-9089-4152-87b1-f1fc78c943c2
          This article is protected by copyright. All rights reserved.

          This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

          Page count
          Figures: 0, Tables: 0, Pages: 22, Words: 631
          Product
          Categories
          Original Contribution
          Original Contributions
          Custom metadata
          2.0
          accepted-manuscript
          Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.7 mode:remove_FC converted:15.09.2021

          Emergency medicine & Trauma
          covid‐19,emergency medicine,public health,vaccination
          Emergency medicine & Trauma
          covid‐19, emergency medicine, public health, vaccination

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