Original Research
Sunday, November 12, 2023
12:45 PM–02:15 PM
Abstract
Introduction: Vaccine-preventable diseases continue to cause morbidity and mortality. The WHO named vaccine hesitancy as a top 10 threat to global health in 2019. Vaccination rates for uninsured adults, especially immigrants, are lower for routine vaccinations than for their insured counterparts. The Birmingham Free Clinic (BFC) provides health services to uninsured individuals in Pittsburgh, with immigrants being the largest patient population.
Research Question or Hypothesis: “What factors influence vaccine acceptance or refusal among uninsured patients?”
Study Design: Single-center cross-sectional study using semi-structured questions to assess factors leading to vaccine acceptance or refusal.
Methods: Between January and March of 2023, patients at BFC were screened for vaccine eligibility using the CDC adult vaccination schedule. Patients missing at least one of the vaccinations (influenza, pneumococcal, hepatitis B, herpes zoster, and tetanus/diphtheria) or not fully vaccinated for COVID-19 were recruited. The interviewers used the Health Belief Model framework to assess factors related to vaccine acceptance or non-acceptance. Data was analyzed using descriptive statistics.
Results: 198 patient charts were reviewed, 44 were screened, and 32 (73%) (including 81% being immigrants) were eligible to participate. Acceptance rates for vaccinations were: 36% (4/11) for influenza, 50% (8/16) for COVID-19, 67% (2/3) for Tdap, 67% (12/18) for PCV20, 73% for zoster (11/15), and 74% (17/23) for Hepatitis B. The most common constructs influencing vaccine acceptance were: perceived susceptibility (influenza), perceived severity (PCV20), perceived benefits (hepatitis B), and cue to action (Tdap). The most common constructs influencing vaccine nonacceptance were: perceived susceptibility (Tdap), and perceived barriers, especially adverse events (COVID-19).
Conclusion: Influenza and COVID-19 had the lowest acceptance rates, driven by perceived susceptibility, perceived barriers, and cue-to-action. Perceived susceptibility and benefits were most consistently associated with vaccine acceptance. Perceived susceptibility, barriers, and cue to action were most consistently associated with overall vaccine hesitancy. A targeted and personalized focus on disease susceptibility and vaccine benefits may increase vaccine acceptance.
Presenting Author
Megan Hutar PharmD Candidate '24University of Pittsburgh School of Pharmacy
Authors
Lauren Jonkman PharmD, MPH
University of Pittsburgh School of Pharmacy
Kate Karlson PharmD Candidate '25
University of Pittsburgh School of Pharmacy
Caroline McKenna PharmD Candidate '24
University of Pittsburgh School of Pharmacy
Andrew Garcia PharmD
UPMC
Sharon E. Connor PharmD
University of Pittsburgh