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流感疫苗社区外展:利用多专业医疗保健学生队伍为边缘化人群接种疫苗。

Influenza vaccine community outreach: Leveraging an interprofessional healthcare student workforce to immunize marginalized populations.

机构信息

Vanderbilt University School of Medicine (VUSM), Nashville, TN, United States of America.

Vanderbilt University School of Medicine (VUSM), Nashville, TN, United States of America.

出版信息

Prev Med. 2021 Jun;147:106460. doi: 10.1016/j.ypmed.2021.106460. Epub 2021 Feb 18.

Abstract

Vulnerable populations such as the uninsured, unemployed, and unhoused face significant morbidity and mortality from influenza but are less likely to receive the annual vaccine and have limited access to medical care. We describe an interprofessional, student-run vaccine outreach program (VOP) in Davidson County, Tennessee that lowers barriers to vaccination through free vaccination events in nontraditional community locations. We provide this framework as a model to expand novel, seasonal, or outbreak-oriented vaccine outreach to resource-poor populations. Demographic data were collected from the patients who received an influenza vaccine between 2015 and 2019 through an optional survey to determine whether these events were reaching unhoused, uninsured, and/or unemployed individuals. Of 1,803 patients, 1,733 (96.1%) completed at least one field of the demographic form. Overall, 481 (27.8%) were individuals without homes or living in temporary housing and 673 (38.8%) were unemployed. Most patients, 1,109 (64.0%), did not have health insurance at any point during the prior two years. With the addition of a nurse practitioner student to VOP leadership, the 2018-2019 VOP reached the most unhoused or temporarily-housed (228, 32.3%), unemployed (313, 18.5%), and disabled (60, 8.5%) patients. The VOP can be adapted to meet community needs, funding, and volunteer interest. The VOP model may be applicable to a SARS-CoV-2 vaccine, especially since the economic impact of COVID-19 has increased unemployment rates and housing instability. Healthcare students serve as an eager, underutilized resource who can be leveraged to disseminate vaccines to individuals with limited access to care.

摘要

弱势群体,如未参保者、失业者和无家可归者,流感发病率和死亡率较高,但他们更有可能无法获得年度疫苗接种,且获得医疗保健的机会有限。我们描述了田纳西州戴维森县的一个跨专业、学生管理的疫苗外展项目(VOP),该项目通过在非传统社区地点举办免费疫苗接种活动,降低了疫苗接种的障碍。我们提供了这个框架,作为向资源匮乏人群推广新型、季节性或突发疫情疫苗接种的模式。我们从 2015 年至 2019 年期间通过可选调查从接受流感疫苗的患者那里收集了人口统计学数据,以确定这些活动是否覆盖到无家可归者、未参保者和/或失业者。在 1803 名患者中,有 1733 名(96.1%)至少填写了人口统计学表格的一个字段。总体而言,481 名(27.8%)患者无家可归或居住在临时住所,673 名(38.8%)失业。大多数患者(64.0%)在过去两年中的任何时候都没有健康保险。随着护士执业学生加入 VOP 领导层,2018-2019 年 VOP 接触到了最多的无家可归者或临时居住者(228 人,32.3%)、失业者(313 人,18.5%)和残疾者(60 人,8.5%)。VOP 可以根据社区需求、资金和志愿者兴趣进行调整。VOP 模式可能适用于 SARS-CoV-2 疫苗,尤其是因为 COVID-19 的经济影响增加了失业率和住房不稳定。医疗保健学生是一种渴望被利用、但尚未充分利用的资源,可以利用他们向难以获得医疗服务的个人传播疫苗。

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