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Use of an Analytics and Electronic Health Record–Based Approach for Targeted COVID-19 Vaccine Outreach to Marginalized Populations

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Equity in vaccine outreach and delivery has been prioritized given the disproportionate harms of the COVID-19 pandemic on communities of color and those with lower socioeconomic status.1,2 Health systems have largely communicated availability or signup for vaccines to patients through electronic patient portal messages, emails, or online materials; however, rates of portal use and internet access are limited among rural populations, individuals with lower socioeconomic status, and racial and ethnic minority patients.3,4 For purposes of this analysis, these groups are referred collectively as marginalized populations. Reliance on these media as the primary means for communication may inadvertently widen vaccination disparities.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: June 29, 2021.

Published Online: August 19, 2021. doi:10.1001/jamaoncol.2021.3833

Corresponding Author: Jacob Stein, MD, MPH, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 170 Manning Dr, 3rd Floor, CB #7305, Chapel Hill, NC 27599 (jacob.stein@unchealth.unc.edu).

Author Contributions Drs Basch and Stein had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Stein, Fasold.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Stein, Fasold, Cheek.

Critical revision of the manuscript for important intellectual content: Stein, Fasold, Daguerre, Richardson, Charlot, Basch.

Statistical analysis: Stein, Fasold.

Administrative, technical, or material support: Stein, Fasold.

Supervision: Fasold, Charlot, Basch.

Other - participated in the project work this article is referencing: Cheek.

Other - active participant in outreach; designed workflows; assisted with edits.: Daguerre.

Other - participated in outreach calls to patients regarding the COVID-19 vaccine: Richardson.

Conflict of Interest Disclosures: Dr Daguerre reported her spouse holding stock in AstraZeneca and CVS outside the submitted work. Dr Basch reported being a scientific advisor/consultant for AstraZeneca, Sivan Healthcare, CareVive Systems, and Navigating Cancer outside the submitted work. No other disclosures were reported.

References
1.
Adhikari  S , Pantaleo  NP , Feldman  JM , Ogedegbe  O , Thorpe  L , Troxel  AB .  Assessment of community-level disparities in coronavirus disease 2019 (COVID-19) infections and deaths in large US metropolitan areas.   JAMA Netw Open. 2020;3(7):e2016938. doi:10.1001/jamanetworkopen.2020.16938PubMedGoogle Scholar
2.
Rubin  EJ , Baden  LR , Del Rio  C , Akusobi  C , Morrissey  S .  Audio interview: delivering Covid-19 vaccines to minority communities.   N Engl J Med. 2021;384(13):e60. doi:10.1056/NEJMe2105496PubMedGoogle Scholar
3.
Greenberg  AJ , Haney  D , Blake  KD , Moser  RP , Hesse  BW .  Differences in access to and use of electronic personal health information between rural and urban residents in the united states.   J Rural Health. 2018;34(suppl 1):s30-s38. doi:10.1111/jrh.12228PubMedGoogle ScholarCrossref
4.
Goel  MS , Brown  TL , Williams  A , Hasnain-Wynia  R , Thompson  JA , Baker  DW .  Disparities in enrollment and use of an electronic patient portal.   J Gen Intern Med. 2011;26(10):1112-1116. doi:10.1007/s11606-011-1728-3PubMedGoogle ScholarCrossref
5.
Dai  M , Liu  D , Liu  M ,  et al.  Patients with cancer appear more vulnerable to SARS-CoV-2: a multicenter study during the COVID-19 outbreak.   Cancer Discov. 2020;10(6):783-791. doi:10.1158/2159-8290.CD-20-0422PubMedGoogle Scholar
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