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

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 HCP, while workflow modifications to streamline vaccine administration were implemented during clinic visits. Structured pre- and post-intervention chart reviews were conducted, and paper-based (and oral) knowledge, attitudes and practices surveys were administered to selected staff and patients, to assess knowledge, attitudes, and vaccine confidence before and after the interventions. 816 charts were reviewed prior to the intervention; 709 charts were reviewed post intervention. 72 patients and 10 HCP pre- and post- intervention surveys were completed. Vaccine uptake was compared to uptake for 2022. Results: Overall vaccination rates at the clinic increased by more than 400% as compared to the prior year. Patients and HCP demonstrated increased vaccine knowledge and confidence, particularly with respect to COVID-19 and HPV vaccines. In contrast, chart reviews of individual patients revealed only slight improvement in vaccination completion rates for those patients over the 1-year period. Conclusion: Substantial increases in vaccine administration 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 HCP. Patients reported higher trust in HCP, compared to other sources, for vaccine information.