Inequitable COVID-19 Vaccine Uptake Among Rehabilitation Patients

ABSTRACT

Background and/or Objectives: There is a paucity of studies evaluating adult vaccine uptake in patients seen by a physiatrist. During the COVID-19 pandemic, it is crucial for physiatrists who regularly care for patients with neurological and musculoskeletal medical conditions to determine if COVID-19 vaccination disparities among these populations may exist. The objective of our study was to evaluate the rates of COVID-19 vaccine uptake in patient seen in an outpatient rehabilitation clinic. Design(s) Retrospective single center study. Setting(s) Outpatient rehabilitation clinic. Participant(s) Adults with neurological or musculoskeletal medical conditions seen at an outpatient rehabilitation clinic between December 1, 2020 and June 30, 2021 with an active Wisconsin Immunization Registry. Intervention(s) Not applicable. Main Outcome Measure(s) The primary outcome was completion of a COVID-19 primary vaccine series in adults seen in an outpatient rehabilitation clinic. Result(s) 1362 patients met the inclusion criteria. 82.6% (n = 1125) completed a COVID-19 vaccination series. We found that those who had not completed a COVID- 19 vaccination series were more likely to be younger (46.6 +/- 14.8 vs 54.3 +/- 15.7;95% Confidence Interval (CI) [0.96-0.98], p< 0.001), identify as non-white (OR 0.50, 95% CI [0.31-0.80], p = 0.004), or be a current smoker (OR 1.80, 95% CI [1.20-2.71], p=0.005). Those who resided in an urban zip code (OR 0.54, 95% CI (0.40-0.72), p < 0.001), received an influenza vaccine during 2019-2020 (OR 0.19, 95% CI [0.14-0.26], p< 0.001), or had a higher comorbidity score (Charleson Comorbidity Index >2) (OR 0.35 [0.23-0.52];p < 0.001) were more likely to be fully immunized. Conclusion(s) There was a high rate of COVID-19 vaccine uptake among patients seen in a rehabilitation clinic, though racial, ethnic and geographic disparities did exist. Further studies are needed to determine why these disparities exist and investigate interventions to increase vaccine uptake in these populations.