Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Penn Acute Research Collaboration, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Acad Emerg Med. 2021 Oct;28(10):1100-1107. doi: 10.1111/acem.14376. Epub 2021 Oct 4.
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.
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.
A total of 1,555 patients were approached, and 1,068 patients completed surveys (completion rate = 68.7%). Mean (±SD) age was 44.1 (±15.5) years (range = 18-93 years), 61% were female, and 70% were Black. A total of 31.6% of ED patients reported vaccine hesitancy. Of note, 19.7% of the hesitant cohort were health care workers. In multivariable regression analysis, Black race (odds ratio [OR] = 4.24, 95% confidence interval [CI] = 2.62 to 6.85) and younger age (age 18-24 years-OR = 4.57, 95% CI = 2.66 to 7.86; age 25-35 years-OR = 5.71, 95% CI = 3.71 to 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 to 4.19). Hesitant patients were significantly less likely to trust governmental sources of vaccine information than nonhesitant patients (39.6% vs. 78.9%, p < 0.001); less difference was noted in the domain of trust toward friends/family (51.1% vs. 61.0%, p = 0.004). Hesitant patients also reported perceived vaccine safety concerns and perceived insufficient research.
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 that strategies to combat hesitancy may need tailoring to specific populations.
广泛接种疫苗是应对 COVID-19 大流行的公共卫生措施的重要组成部分，但疫苗犹豫仍然普遍存在。这项前瞻性调查旨在衡量两家城市急诊部（ED）患者队列中疫苗犹豫的流行程度，并描述导致犹豫的潜在因素。
研究纳入具有稳定临床状态（紧急严重指数 3-5 级）且无活动性 COVID-19 疾病或精神状态改变的成年 ED 患者。收集人口统计学要素以及与接种疫苗相关的报告障碍/关注点和信任的健康信息来源。通过经过培训的研究助理监管的调查工具进行现场数据收集。
共接触了 1555 名患者，其中 1068 名患者完成了调查（完成率为 68.7%）。平均（±SD）年龄为 44.1（±15.5）岁（范围 18-93 岁），61%为女性，70%为黑人。共有 31.6%的 ED 患者报告疫苗犹豫。值得注意的是，犹豫队列中有 19.7%的人是医护人员。多变量回归分析显示，黑人种族（比值比 [OR] = 4.24，95%置信区间 [CI] = 2.62 至 6.85）和年轻（18-24 岁-OR = 4.57，95%CI = 2.66 至 7.86；25-35 岁-OR = 5.71，95%CI = 3.71 至 8.81）与犹豫有更大的关联，程度甚于教育程度（高中或以下学历-OR = 2.27，95%CI = 1.23 至 4.19）。犹豫的患者明显比不犹豫的患者更不信任政府疫苗信息来源（39.6%对 78.9%，p < 0.001）；在信任朋友/家人方面的差异较小（51.1%对 61.0%，p = 0.004）。犹豫的患者还报告了对疫苗安全性的担忧和对研究不足的担忧。
ED 患者中疫苗犹豫很常见，在黑人患者和年轻患者中更为常见，与教育程度无关。犹豫的患者报告对安全性的担忧和对政府信息来源的低信任，但对朋友或家人的信任度较低。这表明，抗击犹豫的策略可能需要针对特定人群进行定制。
