Nearly half of adult patients in US emergency departments had not heard of at least one recommended vaccine, and more than 86% reported missing one or more, according to a multicenter survey conducted from April to December 2024. Almost half of patients not up to date said they would accept missed doses if they were offered during their visit.
The survey included 3,285 adult patients in 10 emergency departments (ED) across 8 US cities. Participants were asked about their awareness and receipt of recommended vaccines, including influenza, tetanus, COVID-19, shingles, pneumococcal, and respiratory syncytial virus, as well as willingness to accept vaccination in the ED. Surveys were conducted in English, Spanish, or Mandarin. Demographics, insurance coverage, housing stability, and access to primary care were also recorded.
Overall, 55% of respondents were female, 30% were Black, 27% were White, and 32% were Hispanic;18% primarily spoke Spanish. Eight percent reported unstable or marginal housing, and 21% had no primary health care source.
Overall, 49% had not heard of at least one recommended vaccine. Lack of vaccine knowledge was more common among men, Black and Hispanic patients, non-English speakers, uninsured patients, and patients without primary care.
Self-reported vaccination coverage was low, with 87% missing one or more recommended vaccines. By age, influenza was the most commonly missed vaccine among patients aged 18 to 49 years, shingles among those aged 50 to 64 years, and respiratory syncytial virus among those aged 65 years and older. Across all groups, 83% reported COVID-19 vaccination, 43% reported tetanus vaccination within the past 10 years, and 42% reported influenza vaccination.
Among 2,821 patients who were not up to date, 46% said they would accept at least one missed vaccine if it were available in the emergency department, and 87% of those said they would accept all missing vaccines. The highest willingness to receive vaccines was reported among patients surveyed in Sylmar, California.
“This ED-based survey identified substantial gaps in knowledge about and receipt of age-recommended vaccines and suboptimal self-reported coverage. Many patients reported that they would accept vaccines if they were offered to them in an ED," said Robert M. Rodriguez, MD, of the Department of Medicine, University of California Riverside School of Medicine, and colleagues, “EDs could be explored as additional sites to offer vaccination screening, recommendations, counseling, and referrals to increase vaccine coverage among underserved populations.”
The most common reasons for missed vaccines were lack of awareness and not being informed that vaccines were recommended. Patients unwilling to accept vaccines cited feeling too ill or wanting more information.
The study had several limitations. Vaccination status was self-reported, as no centralized adult vaccination registry was available, raising the possibility of recall errors. Patients may have remembered recent vaccines more accurately than those received years earlier. In addition, the findings may not apply to other emergency department populations, and willingness to be vaccinated could have been influenced by social desirability.
Full disclosures can be found in the study.
Source: CDC