676 - A Randomized Controlled Trial of Enhanced Outreach to Increase COVID-19 Vaccination for Children with Chronic Health Conditions from Under Resourced Communities​

Publication Number: 676.3941

Sameer Patel, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Elaine P. Coldren, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Tonya Scardina, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States; Rohan M.. Shah, Feinberg School of Medicine, Chicago, IL, United States; Shan Sun, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States

Background: Patients who are up to date with COVID-19 vaccine booster doses have a lower risk of severe illness and hospitalization from COVID-19, compared to those who are unvaccinated or who have only received the primary series. Childhood opportunity index (COI) is a zip-code based federal metric of neighborhood resources important for children’s healthy development.

Objective: The specific aim of this study was to determine if targeted outreach to parents of children with chronic health conditions who live in neighborhoods with low childhood opportunity can increase the receipt of COVID-19 bivalent booster vaccination when compared to MyChart messaging or no intervention.

Design/Methods: Eligible study patients were aged 6 months to 18 years, who met the following criteria: 1) receipt of primary care at a federally qualified health center (FQHC), 2) residence in zip codes with low or very low COI, 3) chronic health condition(s), and 4) incomplete COVID-19 vaccination status. Patients were randomized to either: 1) no intervention, 2) MyChart reminders, or 3) enhanced outreach consisting of a phone call to parents to discuss vaccine benefit individualized to their child. Patients in the two intervention arms were contacted between 12/01/23 and 2/28/24. Parents in the enhanced outreach arm were queried about reasons for non-receipt of the vaccine booster. The primary study outcome was the proportion of patients who received a booster vaccine dose within 90 days.

Results: Overall, 105 patients were randomized to each of the three study arms. The median age was 11.3 years. Of the parents, 57% (n=178) spoke English as a primary language, and 43% (n=137) spoke Spanish. Ninety-three percent (n=294) had public insurance. The most common chronic conditions were cardiovascular (74%, n=232), congenital (41%, n=129) and neuromuscular (37% n=117). The most common reasons stated for non-receipt of the booster vaccine were 1) planning to but have not done so yet (46%, n=48), did not know there was another booster vaccine recommended (26%, n=27), and concerned about side effects (15%, n=16). The proportion of patients who received a subsequent COVID-19 vaccine in the control, MyChart reminder, and enhanced outreach arms were 12% (n=13), 12.3% (n=14), and 21% (n=22), respectively (p=0.19).

Conclusion(s): Despite a population of children with chronic health conditions, COVID-19 booster vaccination rates were low in all 3 study arms and did not differ. Most parents expressed willingness to receive future booster doses and increased opportunities for administration outside of well child visits may increase vaccine uptake.