title: Survey of vaccination knowledge and acceptance among adults admitted to an urban emergency department.
abstract: Adult vaccination rates in the United States have fallen below national target levels and may be exacerbated by lack of access to a primary care physician. We assessed patient knowledge of and attitudes towards vaccines in an urban emergency department population and analyzed the feasibility of using this setting as a vaccine delivery site from a patient perspective.
  
  
  
  In-person interviewers administered surveys to 250 adult patients presenting to the Detroit Receiving Hospital emergency department in Detroit, Michigan. Respondents were asked about vaccination status, preferences, and willingness to accept vaccination reminders via text messaging. Odds ratios and 95% Wald confidence intervals assessing differences between vaccinated and non-vaccinated individuals were generated with univariate logistic regression.
  
  
  
  Vaccinated adults were more likely to have a primary care provider than non-vaccinated adults (OR 1.94, 95% CI: 1.09-3.45). Non-vaccinated adults were significantly more likely to have unvaccinated adult relatives (OR8.64, 95% CI: 4.10-18.22). Nearly all respondents used a cell phone, and 75.8% of unvaccinated adults were willing to receive text messages reminders about vaccines.
  
  
  
  Although less likely to have a primary care access point than vaccinated participants, non-vaccinated respondents reported interest in receiving vaccinations. Emergency departments could serve as vaccination hubs for patients and unvaccinated accompanying family members. Text message reminders offer a potential source of additional vaccine prompts and education.
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104, United States.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Sutcliffe
authors.affiliation: Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Bldg 259 Mack Ave, Detroit, MI 48201, United States.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Kilgore
authors.affiliation: Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Bldg 259 Mack Ave, Detroit, MI 48201, United States.
authors.forename: Kaitlyn
authors.initials: K
authors.lastname: DeHoff
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104, United States.
authors.forename: Richard
authors.initials: R
authors.lastname: Evans
authors.affiliation: School of Medicine, Wayne State University, 540 Canfield St, Detroit, MI 48201, United States; University of Michigan Medical School, 1150 W. Medical Center Drive, Ann Arbor, MI 48109, United States.
authors.forename: Keith S
authors.initials: KS
authors.lastname: Kaye
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104, United States.
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Malosh
authors.affiliation: School of Medicine, Wayne State University, 540 Canfield St, Detroit, MI 48201, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Sherwin
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104, United States. Electronic address: etmartin@umich.edu.
authors.forename: Emily T
authors.initials: ET
authors.lastname: Martin
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000517:prevention & control; D001428:Bacterial Vaccines / Q000008:administration & dosage*; D002947:Cities; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D017010:Reminder Systems / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D060145:Text Messaging / Q000706:statistics & numerical data; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data; D014765:Viral Vaccines / Q000008:administration & dosage*; D014777:Virus Diseases / Q000517:prevention & control
chemical_list: D001428:Bacterial Vaccines; D014765:Viral Vaccines
keywords: Adult; Emergency department; Influenza; Urban