# Oportuna Vacuna: A Prospective Study of Vaccine Confidence and Vaccine Uptake in a Low-Income, Spanish-Speaking Rhode Island Population in the Post-Pandemic Era

## TL;DR

A clinic in Rhode Island improved vaccine uptake among Spanish-speaking, low-income patients by over 400% through education and workflow changes.

## Contribution

Demonstrates the effectiveness of culturally tailored education and workflow adjustments in boosting vaccine confidence and uptake in underserved populations.

## Key findings

- Vaccination rates increased by over 400% compared to the prior year.
- Patients and healthcare providers showed improved vaccine knowledge and confidence, especially for COVID-19 and HPV vaccines.
- Workflow modifications and educational sessions were well-received and contributed to higher vaccine administration efficiency.

## Abstract

Background: Clínica Esperanza/Hope Clinic (CEHC), a free clinic for low-income, uninsured, Spanish-speaking patients, located in Providence, RI, piloted an intervention to improve vaccination rates. This program, named “Oportuna Vacuna” (OV) aimed to assess vaccine hesitancy in the post-pandemic period and measure improvements to vaccine uptake after integrating healthcare provider (HCP) and patient education with vaccine workflow adjustments. Methods: OV was initiated in January 2023. Culturally attuned and linguistically appropriate vaccine-focused educational programs were developed and provided to patients and HCPs, while workflow modifications to streamline vaccine administration were implemented during clinic visits. Structured pre- and post-intervention chart reviews were conducted and (oral- and) paper-based knowledge, attitudes, and practices surveys were administered to selected staff and patients to assess knowledge, attitudes, and vaccine confidence before and after the interventions. A total of 816 charts were reviewed prior to the intervention; 709 charts were reviewed post-intervention. A total of 72 patient and 10 HCP pre- and post- intervention surveys were completed. Vaccine uptake was compared to the uptake in 2022. Results: Overall vaccination rates at the clinic increased by more than 400% compared to the prior year. Patients and HCPs demonstrated increased vaccine knowledge and confidence, particularly with respect to COVID-19 and HPV vaccines. In contrast, chart reviews of individual patients revealed only a slight improvement in vaccination completion rates for patients over the 1-year period. Conclusion: Substantial increases in vaccine administration rates across multiple vaccine types highlight the effectiveness of OV, mainly for first time patients, at CEHC. Clinic workflow modifications improved vaccination efficiency and increased vaccine uptake. Educational sessions on vaccines were well received by patients and staff. Overall knowledge about vaccines improved during the intervention among staff and HCPs. Patients reported higher trust in HCPs compared to other sources for vaccine information.