PROmotion of COVid-19 VA(X)ccination in the Emergency Department - PROCOVAXED

Project Summary/Abstract
Broad population immunization is the ultimate mitigation measure for the SARS-CoV-2 (COVID-19) pandemic.
Our research team recently conducted the Rapid Evaluation of COVID-19 Vaccination in Emergency
Departments for Underserved Patients (REVVED UP) study that identified a particularly vulnerable population
whose primary (and often only) health care access occurs in emergency departments (EDs). This group faces
major barriers, especially vaccine hesitancy and limited vaccination site access, to receiving COVID-19 and
influenza vaccines. African Americans and Latinos, who have suffered disproportionately high morbidity and
mortality from the COVID-19 pandemic, comprise 66% of this ED Usual Source of Care group of patients. The
goal of this research is to promote equity and increase COVID-19 and influenza vaccine acceptance and
uptake in ED Usual Source of Care patients by developing and delivering trusted messaging and informational
platforms (PROmotion of COvid-19 VA(X)ccination in the Emergency Department – PROCOVAXED) that
address vaccination barriers, especially vaccine hesitancy.
The investigator team, consisting of diverse faculty at four US medical schools, has substantial experience in
addressing health care disparities in ED populations, including those that relate to vaccine uptake and
hesitancy. Toward gaining insight about effective trusted messaging (Specific Aim I), we will convene and meet
with ED Usual Source of Care patient focus groups, consisting of people whose primary health care access is
in EDs and members of community partner organizations that serve those populations, in four cities (San
Francisco, Philadelphia, Seattle, and Durham, North Carolina). In Specific Aim II we will harmonize data from
our focus group meetings with other modules and instruments from national repositories (e.g., the Social
Determinants of Health Collection of the PhenX Toolkit) to produce PROCOVAXED platforms, consisting of
video clips, printed materials and face-to-face patient messaging that address ED Usual Source of Care
patients' barriers to COVID-19 and influenza vaccination, especially vaccine hesitancy. Toward Specific Aims
III and IV, we will then conduct a 14-month cluster-randomized, controlled trial of PROCOVAXED platform
implementation in six safety net EDs (intervention delivered during patient ED visits), testing the hypothesis
that implementation of PROCOVAXED trusted messaging platforms in EDs is associated with increased
acceptance and uptake of COVID-19 and influenza vaccines in ED Usual Source of Care Patients.
We have engaged a powerful set of stakeholders, including six major hospital systems, seven minority
advocacy and faith-based organizations, and the two largest US Emergency Medicine professional
organizations, who are committed to disseminating our findings and broadly implementing PROCOVAXED
platforms. Our research will be a public health game-changer that paves the way towards ED-based public
health messaging and delivery of COVID-19 and influenza vaccines to vulnerable, hard to reach populations.