Implementation of In-Clinic SARS-CoV-2 Vaccination in Advanced Heart Failure, Lung Disease, and Transplant Clinic

Abstract

PurposeVaccine hesitancy is a hurdle to achieving full vaccination against SARS-CoV-2 in the U.S. In an effort to address vaccine hesitancy among the high-risk group of advanced heart and lung disease and post-heart and lung transplant patients, we implemented an in-clinic vaccination program. Starting 9/9/2021, we offered the Pfizer/BioNTech SARS-CoV-2 mRNA vaccine in clinic to eligible individuals, including patient family members who were patients in our healthcare system. We sought to describe the results of the first month of implementing an in-clinic SARS-CoV-2 vaccination effort.MethodsWe reviewed the experience of providing SARS-CoV-2 vaccination in clinic during the first four weeks of the program (9/9/2021-10/7/2021). Recipients’ charts were reviewed for clinical details. We also compared demographics of the in-clinic recipients to those of patients who received inpatient dosing of the same vaccination at our hospital.ResultsFrom 9/9-10/7/2021, 222 SARS-CoV-2 vaccines were administered in clinic. Average age of recipients was 60 (±15) years. 64 (29%) were given in the heart failure/transplant clinic; 107 (48%) were given in the advanced lung/transplant clinic; 50 (22.5%) were administered to healthcare workers, 10 (4.5%) were administered to family members of patients. 50 (22.5%) were post-transplant patients. Nineteen (8.6%) were the patients’ first dose; 200 (90%) were third doses (booster or third dose for immune compromised). During this time period, 12 doses of vaccine were discarded due to expiration after thawing in our outpatient setting. During the same period, 115 inpatient doses of the vaccine were given. Average age of inpatient recipients was 51 (±17) years. Ninety-one (79%) of inpatient administrations were first doses.ConclusionInpatient vaccination was more likely to reach younger and unvaccinated patients, while in-clinic vaccination in advanced heart/lung disease outpatient clinic was more likely to complete a three-dose series for immune-compromised patients or booster dosing for high-risk patients/staff. Additional study on the impact of offering SARS-CoV-2 vaccination in-clinic on combatting vaccine hesitance is necessary. This study is limited because we only provided Pfizer/BioNTech vaccines; different effects may be seen in clinics that also offer other FDA approved SARS-CoV-2 vaccines.