A new study co-authored by UCLA Health researchers found that nearly nine in ten emergency department patients have not received one or more recommended vaccines, with about half unaware that these vaccines were even recommended for them. The findings reveal critical gaps in preventive care among underserved populations who rely on emergency departments as their primary healthcare access point.
Why it matters
About 30% of the U.S. population lacks access to primary care and relies exclusively on places like emergency departments for healthcare. This group includes people without insurance, many homeless individuals, and immigrants, populations that often fall through the cracks in traditional healthcare systems. Finding new ways to deliver vaccines, which have saved more lives than almost any other public health intervention, to underserved communities is essential for public health.
What the study did
Researchers conducted the first national comprehensive vaccine surveillance study in emergency departments across eight U.S. cities. Between April and December 2024, they surveyed 3,285 non-critically ill adult patients visiting 10 emergency departments for reasons like minor injuries or illnesses. Patients were asked age-specific questions about recommended vaccines, including shingles, pneumococcal, RSV, tetanus, COVID-19, and influenza. For each recommended vaccine, researchers asked if patients had heard of it, whether they had received it, and if not, why. They also asked whether patients would accept vaccines if offered during their ED visit.
What they found
Nearly nine in ten emergency department patients (86%) had not received one or more recommended vaccines, and about half (49%) were unaware of vaccines recommended for them. Lack of vaccination was more common among African Americans, uninsured individuals, and those without a primary care provider. Roughly half of unvaccinated participants said they would accept vaccines if offered during their ED visit, suggesting significant potential for improvement, since currently, only 14% of adult ED patients are fully up-to-date on their vaccines. If implemented widely, ED-based vaccine programs could increase fully vaccinated rates to as high as 48%, more than tripling current rates.
What's next
Researchers will explore ways to automate the vaccination screening process to make it less labor-intensive for emergency departments. They're also investigating mobile outreach options for people who cannot access emergency departments. The team calls for collaborations between public health officials and ED personnel to create effective programs for vaccine screening, outreach, and delivery.
From the experts
"Emergency departments represent a critical touchpoint for reaching patients who may otherwise never encounter the healthcare system for preventive care," said Dr. Jesus R. Torres, assistant professor in the UCLA Department of Emergency Medicine at the David Geffen School of Medicine and study co-author. "Our findings demonstrate that ED-based vaccination programs could serve as a powerful tool for advancing health equity, particularly for communities that have been historically underserved by traditional healthcare delivery models."
About the study
Rodriguez RM, Torres JR, Chinnock B, et al. Emergency Department Survey of Vaccination Knowledge, Vaccination Coverage, and Willingness to Receive Vaccines in an Emergency Department Among Underserved Populations — Eight U.S. Cities, April–December, 2024. MMWR Morb Mortal Wkly Rep 2025;74:456–462. DOI: http://dx.doi.org/10.15585/mmwr.mm7429a1 .
About the Research Team
The study was led by Dr. Robert Rodriguez at UC Riverside, with colleagues at UCLA, UC San Francisco, Thomas Jefferson University in Pennsylvania, Wayne State University in Michigan, Rush University Medical Center in Illinois, and Duke University in North Carolina.
Funding and Disclosures
The study was supported in part by a grant from the National Institute of Allergy and Infectious Diseases.
