Educational Messaging Increases COVID-19 Vaccine Acceptance and Uptake

Providing COVID-19 vaccine educational messaging platforms in emergency departments (EDs) increases vaccine acceptance and uptake in unvaccinated patients, particularly in underserved communities, according to a new study published in JAMA Internal Medicine.

COVID resulted in more than 1 million deaths in the US as of May 2022, and it is estimated that 58% of these deaths could have been prevented by timely COVID vaccination. Despite the robust efficacy of COVID vaccines, almost a quarter of the US population remains vaccine hesitant.

Underserved Communities Need to Be Reached

Minority groups like African Americans and Latinx persons are at a higher risk for poor outcomes from COVID infection, and EDs are positioned to serve as critical intervention sites for these communities. A previous analysis showed that patients whose primary care occurs in EDs had a higher rate of vaccine hesitancy than patients treated with primary care. As a result of this disparity, researchers conducted in-depth interviews of 65 ED patients with vaccine hesitancy whose primary care took place in EDs during the summer and fall of 2021. They used the results to construct the ED population-specific Promotion of COVID-19 Va(X)ccination in the Emergency Department (PROCOVAXED) messaging platforms – a series of messaging initiatives consisting of videos, informational flyers, and scripts for face-to-face messaging – in an effort to improve vaccine uptake.

In this analysis, the aforementioned 3-pronged COVID vaccine messaging platforms were delivered during patient waiting times. The two primary outcomes of interest were stipulated as COVID-19 vaccine acceptance, assessed by survey responses in the ED, and receipt of a COVID-19 vaccine within 30 days. In total, 496 participants were enrolled (221 during interventional weeks, and 275 during control weeks of no messaging).

A Successful Intervention

The results of the study found that delivery of COVID-19 vaccine messaging platforms resulted in appreciably higher vaccine acceptance among intervention group participants compared with the control group (25.8% vs 12.0%) as well as uptake within 30 days (20% vs 8.7%). The impact of the intervention was greater in Latinx persons and participants without primary care physicians.

“Results of this cluster randomized clinical trial showed that with low NNT (number needed to treat), implementation of COVID-19 vaccine messaging platforms in EDs leads to greater vaccine acceptance and uptake in unvaccinated ED patients,” the researchers concluded. They added that broad implementation (of messaging) in EDs “could lead to greater COVID-19 vaccine delivery to underserved populations whose primary health care access occurs in EDs.”