Social and structural determinants of COVID-19 vaccine uptake among racial and ethnic groups

Peña, Juan M.; Schwartz, Matthew; Hernandez-Vallant, Alexandra; Sánchez, Gabriel R.

doi:10.1007/s10865-023-00393-y

Cited by 14 publications

(9 citation statements)

References 45 publications

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“…Moreover, worry about others’ health and fear of transmitting COVID-19 were positively associated with vaccine likelihood. Peña et al ( 2023 ) report findings from a survey of several racial/ethnic groups (Latino/Hispanic, African American/Black, Asian American and Pacific Islander, Native American, White) to understand differences in COVID-19 vaccine hesitancy. First, Latino and Black respondents were less likely to be vaccinated.…”

Section: Minority Health and Health Disparitiesmentioning

confidence: 99%

Broad perspectives in understanding vaccine hesitancy and vaccine confidence: an introduction to the special issue

2023

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The World Health Organization has designated vaccine hesitancy and vaccine confidence among the most pressing issues in global health. The COVID-19 pandemic has made vaccine hesitancy and vaccine confidence particularly salient and urgent. The purpose of this special issue is to highlight a broad range of perspectives on these critical issues. We have included a total of 30 papers that address issues related to vaccine hesitancy and vaccine confidence across multiple levels of the Socio-Ecological Model. We have organized the empirical papers into the following sections: individual-level beliefs, minority health and health disparities, social media and conspiracy beliefs, and interventions. In addition to the empirical papers, three commentaries are included in this special issue.

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Section: Minority Health and Health Disparitiesmentioning

confidence: 99%

Broad perspectives in understanding vaccine hesitancy and vaccine confidence: an introduction to the special issue

2023

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“…9,10 Additionally, inpatient vaccinations represent a unique opportunity to provide needed health services to underserved patient populations with resource restrictions. [11][12][13][14] One solution to increase vaccination rates is to utilize clinical decision support systems (CDSSs), which use pertinent patient information to guide and improve health-related decision-making. 15,16 A commonly utilized subset of CDSS is the electronic health record (EHR) alert, which has been effective in capturing vaccine-eligible subjects.…”

Section: Background and Significancementioning

confidence: 99%

An Electronic Health Record Alert for Inpatient Coronavirus Disease 2019 Vaccinations Increases Vaccination Ordering and Uncovers Workflow Inefficiencies

Black,

Snyder,

Zhou

et al. 2024

Appl Clin Inform

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Background: Despite mortality benefits, only 19.9% of US adults are fully vaccinated against the coronavirus disease 2019 (COVID-19). The inpatient setting is an opportune environment to update vaccinations, and inpatient electronic health record (EHR) alerts have been shown to increase vaccination rates. Objective: Evaluate if an EHR alert could increase COVID-19 vaccinations in eligible hospitalized adults by prompting providers to order the vaccine. Methods: This was a quasi-experimental pre-post interventional design study at an academic and community hospital in the western United States between 1/1/2021 and 10/31/2021. Inclusion criteria were unvaccinated hospitalized adults. A soft-stop, interruptive EHR alert prompted providers to order COVID-19 vaccines for those with an expected discharge date within 48 hours and interest in vaccination. The outcome measured was the proportion of all eligible patients for whom vaccines were ordered and administered before and after alert implementation. Results: Vaccine ordering rates increased from 4.0% to 13.0% at the academic hospital (OR 4.01, 95% CI 3.39 to 4.74, p < 0.001) and from 7.4% to 11.6% at the community hospital (OR 1.62, 95% CI 1.23 to 2.13, p < 0.001) after alert implementation. Administration increased post-alert from 3.6% to 12.7% at the academic hospital (OR 3.21, 95% CI 2.70 to 3.82, p < 0.001), but was unchanged at the community hospital, 6.7% to 6.7% (OR 0.99, 95% CI 0.73 to 1.37, p = 0.994). Further analysis revealed infrequent vaccine availability at the community hospital. Conclusion: Vaccine ordering rates improved at both sites after alert implementation. Vaccine administration rates, however, only improved at the academic hospital, likely due in part to vaccine dispensation inefficiency at the community hospital. This study demonstrates the potential impact of complex workflow patterns on new EHR alert success and provides rationale for subsequent qualitative workflow analysis with alert implementation.

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“…These include ethnicity, socioeconomic status, distrust, political affiliation, misinformation, and a culturally insensitive healthcare system as causes of vaccine hesitancy. These factors impact health disparities and are associated with vaccine intention [52][53][54][55][56][57]. A few studies have researched COVID-19 vaccine hesitancy and older adults using state-level data.…”

Section: Introductionmentioning

confidence: 99%

Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States

Kalu,

Shah,

Tung

et al. 2024

Vaccines

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State-level COVID-19 vaccination rates among older adults have been uneven in the United States. Due to the immunocompromised nature of older adults, vaccine hesitancy increases the risk of morbidity and mortality. This study aims to determine the association between the social determinants of health, the structural determinants of health, and COVID-19 vaccine hesitancy among older adults in the United States. Secondary data from the Health and Retirement Study (HRS) dataset were used. A descriptive analysis and multinomial multivariable logistic regression were performed to examine the association of the independent variables—gender, age, race, immigration status, marital status, broadband internet access, social security income, Medicare coverage, education, and frequency of religious service—with the dependent variable, vaccine hesitancy. Compared to the respondents with no vaccine hesitancy and without the specific predictor, the respondents who reported religious attendance at least once/week were more likely to be “somewhat hesitant”, divorced respondents had higher odds of being “somewhat hesitant”, and older adults aged 65–74 years were more likely to be “very hesitant” or “somewhat hesitant” about the COVID-19 vaccine. Compared to the respondents with no vaccine hesitancy and without the specific predictor, females had higher odds of being “very hesitant”, “somewhat hesitant”, or a “little hesitant”, and African Americans were more likely to be “very hesitant”, “somewhat hesitant”, or a “little hesitant” about the COVID-19 vaccine. Addressing these factors may limit the barriers to vaccine uptake reported among older adults and improve herd immunity among the immunocompromised population.

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Social and structural determinants of COVID-19 vaccine uptake among racial and ethnic groups

Cited by 14 publications

References 45 publications

Broad perspectives in understanding vaccine hesitancy and vaccine confidence: an introduction to the special issue

Broad perspectives in understanding vaccine hesitancy and vaccine confidence: an introduction to the special issue

An Electronic Health Record Alert for Inpatient Coronavirus Disease 2019 Vaccinations Increases Vaccination Ordering and Uncovers Workflow Inefficiencies

Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States

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