University of Wisconsin–Madison Medical College of Wisconsin

High but Inequitable COVID-19 Vaccine Uptake Among Rehabilitation Patients

Alyssa Warden, DO; Jonathan Liang, DO; Kaitlyn J, Vanias, MD; Scott Hetzel, MS; Mary S. Hayney, PharmD, MPH; Jennifer M. Weiss, MD, MS; Freddy Caldera, DO, MS; Kristin Caldera, DO

WMJ. 2023;122(5):444-449

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Introduction: There is a paucity of studies evaluating vaccine uptake in adults with neurological and musculoskeletal medical conditions. We sought to evaluate the rates of COVID-19 vaccine uptake in patients seen in an outpatient rehabilitation clinic.

Methods: We conducted a retrospective, single center study of adults seen at an outpatient rehabilitation clinic from December 1, 2020, through June 30, 2021, with an active Wisconsin Immunization Registry record. The primary outcome was completion of a COVID-19 primary vaccine series.

Results: Of 1362 patients, 83.3% completed a COVID-19 vaccination series. Younger patients had increased odds of not completing a COVID-19 vaccination series (mean [SD] 46.7 [14.7] vs 54.3 [15.8]; OR 1.03; 95% CI, 1.02-1.04; P < 0.001). Those who identified as non-White (1.88; 95% CI, 1.16-3.04; P = 0.010) or current smoker (1.85, 95% CI, 1.85-2.79; P = 0.004) had increased odds of not completing a COVID-19 vaccination series. Those who resided in rural ZIP codes (1.81; 95% CI, 1.35-2.43; P < 0.001), had not received a 2019-2020 influenza vaccine (5.13; 95% CI, 3.79-6.96; P < 0.001), or had lower comorbidity scores (2.95; 95% CI, 1.98-4.41; P < 0.001) had higher odds of not completing a COVID-19 vaccination series.

Conclusions: There was a high rate of COVID-19 vaccine uptake among patients seen in a rehabilitation clinic, though racial, ethnic, and geographic differences did exist. Further studies are needed to determine why these disparities exist and investigate interventions to increase vaccine uptake in these populations.

Author Affiliations: Department of Orthopedics and Rehabilitation Medicine, University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, Wisconsin (Warden, Liang, Vanias, Caldera K); Department of Biostatistics and Medical Informatics, UWSMPH, Madison, Wis (Hetzel); (School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin (Hayney); Department of Medicine, Division of Gastroenterology and Hepatology, UWSMPH, Madison, Wis (Weiss, Caldera F).
Corresponding Author: Kristin Caldera, DO, 1685 Highland Ave, Madison, WI 53705; email
Funding/Support: This study was supported by a grant from the Wisconsin Partnership Program.
Financial Disclosures: Dr F Caldera reports receiving consulting fees from GSK, Takeda Pharmaceuticals, and Celgene; Dr Hayney reports receiving consulting fees from Seqirus and GSK Vaccine.
Acknowledgements: The authors are grateful to Erick Warden for his assistance with data organization and processing.

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