In an unprecedented nationwide effort, a team of researchers led by the University of California, Riverside has unveiled startling findings about vaccination awareness and uptake among underserved populations who rely heavily on emergency departments (EDs) for healthcare access. Their comprehensive study, recently published in Morbidity and Mortality Weekly Reports, represents the first systematic vaccine surveillance conducted within EDs—a critical healthcare touchpoint for millions of Americans who often evade traditional healthcare systems. This groundbreaking research sheds light on the pervasive gaps in vaccine knowledge and administration, detailing new pathways to bolster immunization rates among vulnerable groups through innovative public health interventions.
The investigation spanned from April through December 2024, encompassing a robust survey of over 3,200 non-critically ill adult patients across ten emergency departments situated in eight diverse U.S. cities. These individuals, visiting EDs primarily for minor injuries or illnesses, provided critical data about their awareness of and vaccination status for age-appropriate vaccines, including those for shingles, pneumococcal disease, respiratory syncytial virus (RSV), tetanus, COVID-19, and influenza. Notably, nearly half of those surveyed (approximately 49%) were ignorant of one or more vaccines recommended for their demographic, while a staggering 86% reported missing at least one of these critical immunizations. Such statistics underscore the urgent need to rethink and restructure vaccine delivery strategies.
Dr. Robert Rodriguez, professor of medicine and associate dean of clinical and population health research at UCR’s School of Medicine and lead author of the study, emphasizes that vaccination screening is fundamental to public health and yet remains woefully inaccessible for large swaths of the population. Traditional vaccine survey tools, such as the National Health Interview Survey, have systemic limitations due to their reliance on home visits and phone calls, modalities that exclude unhoused populations and those without stable contact information. EDs, by contrast, represent a unique and crucial healthcare access point, particularly for marginalized groups who lack regular primary care.
A critical revelation of the study was that vaccine underutilization and lack of awareness disproportionately affect African Americans, uninsured individuals, and those without a designated primary care provider. Around 30% of the U.S. populace—many of whom are uninsured, homeless, or immigrants—depend exclusively on emergency departments for their medical needs. These communities often slip through the cracks of traditional preventive healthcare systems, amplifying health disparities. Dr. Rodriguez stresses the potent role EDs can play by instituting systematic vaccine screening programs, which could feasibly triple the proportion of fully vaccinated adults from the current 14% to approximately 48%.
The researchers employed a methodical survey approach, asking patients detailed questions about their knowledge, receipt, and potential acceptance of recommended vaccines. Interestingly, about half of those not up-to-date on vaccinations expressed a willingness to receive immunizations if offered during their ED visits. This finding suggests untapped potential for on-site vaccine delivery programs that could simultaneously raise community immunity levels and bridge equity gaps.
From a technical standpoint, integrating vaccine screening in emergency care settings presents operational challenges. These include the need to develop streamlined protocols that minimize added staff workload and training, coordinate vaccine supply logistics within an already high-pace environment, and establish robust referral networks for vaccines not stocked in EDs. The researchers advocate a multidisciplinary public health collaboration model wherein ED personnel work alongside local clinics, pharmacies, and public health agencies to create seamless vaccination pathways. Such integrative approaches would ensure patients identified as vaccine-eligible could receive timely follow-up in appropriate settings.
Beyond immediate implementation, the team is delving into innovations aimed at automating vaccine screening through electronic health record (EHR) integration and artificial intelligence-driven decision support, reducing the burden on clinical staff. Additionally, mobile outreach programs are in development to reach those unable to physically visit EDs, extending the reach of vaccine equity initiatives into communities’ most underserved sectors.
This pioneering research transcends traditional epidemiological boundaries by highlighting emergency departments as more than mere venues for acute care, positioning them as vital hubs for preventive health interventions. With millions of American adults falling short on vaccine coverage—a deficiency that exacerbates vulnerability to preventable diseases—the study offers a timely clarion call for reimagining vaccination strategies within the complex fabric of healthcare access inequities.
The implications are substantial, particularly as vaccine-preventable illnesses continue to impose significant burdens on public health infrastructure and individual well-being. By leveraging the high patient volume and unique demographic reach of EDs, health systems can interrupt cycles of vaccine neglect, ultimately reducing morbidity and mortality rates associated with diseases like COVID-19 and influenza. Moreover, this approach aligns with wider healthcare goals of improving social determinants of health and closing gaps wrought by systemic inequities.
In summary, Dr. Rodriguez and his colleagues chart a visionary course for transforming emergency departments into proactive agents of vaccine surveillance and delivery. Their findings compel policymakers, healthcare leaders, and public health practitioners to channel resources toward embedding vaccine initiatives directly within ED workflows. The prospect of tripling vaccination completion rates among the most underserved is not just an aspirational target but a feasible outcome, contingent on committed collaboration and innovative deployment of healthcare technologies.
As the study’s co-investigators from UCLA, UC San Francisco, Thomas Jefferson University, Wayne State University, Rush University Medical Center, and Duke University prepare for the next phase of research, the focus sharpens on scalable intervention models. Future efforts will concentrate on validating automated screening tools and piloting mobile outreach programs that further dismantle barriers to vaccine access among marginalized populations. The ultimate vision is a healthcare ecosystem in which every individual’s immunization status is accurately tracked and optimized, irrespective of socioeconomic or geographic constraints.
With rising awareness of vaccine hesitancy and access challenges worldwide, this ED-based vaccine surveillance study arrives as a pivotal chapter in the ongoing public health narrative. The data-driven insights it provides advocate for a paradigm shift that views emergency departments not only as lifesaving acute care centers but as central players in the broader vaccine equity movement. Expanding vaccination coverage among populations historically bypassed by traditional systems is vital to safeguarding collective health and achieving enduring disease prevention.
This study received support from a grant provided by the National Institute of Allergy and Infectious Diseases, enabling a wide-ranging and methodologically rigorous survey effort. The publication titled “An Emergency Department-Based Vaccine Surveillance Study of Underserved Populations — eight U.S. cities, April–December 2024” adds a critical dimension to vaccine research literature and forms a foundation upon which innovative public health practices can be built to address pressing inequities. As ongoing efforts evolve, the integration of emergency care and preventive health services stands poised to reshape vaccination paradigms in America and beyond.
Subject of Research: People
Article Title: An Emergency Department-Based Vaccine Surveillance Study of Underserved Populations — eight U.S. cities, April–December 2024
News Publication Date: 7-Aug-2025
Web References: https://www.cdc.gov/mmwr/volumes/74/wr/mm7429a1.htm
References: National Institute of Allergy and Infectious Diseases grant-supported study as published in Morbidity and Mortality Weekly Reports
Keywords: vaccine surveillance, emergency departments, vaccination rates, underserved populations, vaccine equity, public health intervention, immunization screening, health disparities, COVID-19 vaccine, influenza vaccine, healthcare access, automated screening
