Patients' Perspectives on Emergency Department COVID-19 Vaccination and Vaccination Messaging Through Randomized Vignettes
Author ORCID Identifier
Michael J. Waxman: https://orcid.org/0000-0002-3697-8954
Maile Ray: https://orcid.org/0000-0002-0548-6762
Elissa M. Schechter-Perkins: https://orcid.org/0000-0003-1798-9663
Fiona Berry: https://orcid.org/0000-0001-8128-6765
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: ageyears, 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.
Waxman, M. J., Ray, M., Schechter-Perkins, E. M., Faryar, K., Flynn, K. C., Breen, M., Wojcik, S. M., Berry, F., Zheng, A., Ata, A., Lerner, E. B., Lyons, M. S., & McGinnis, S. (2022). Patients' perspectives on emergency department COVID-19 vaccination and vaccination messaging through randomized vignettes. Public Health Reports, 137(4), 774–781. https://doi.org/10.1177/00333549221085580