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Review
. 2025 Feb;51(1):61-73.
doi: 10.1016/j.rdc.2024.09.007. Epub 2024 Oct 11.

Interventions to Improve COVID-19 Vaccine Hesitancy

Nnenna Ezeh  1 , Taussia Boadi  2 , Maria I Danila  3 , Rosalind Ramsey-Goldman  4 , Candace H Feldman  5
Affiliations
Review

Interventions to Improve COVID-19 Vaccine Hesitancy

Nnenna Ezeh et al. Rheum Dis Clin North Am. 2025 Feb.

Abstract

Coronavirus disease 2019 (COVID-19) vaccine uptake among individuals with rheumatic conditions remains low despite heightened risk for related adverse outcomes. This is especially pronounced among historically marginalized populations who suffered disproportionately from the COVID-19 pandemic. Among the myriad of reasons for low vaccine uptake, mistrust in the healthcare system, misinformation related to the vaccine development process, fear of rheumatic disease flares, and inconsistent physician recommendations, are highlighted. Two randomized controlled trials are underway leveraging multimodal strategies and community partnerships to disseminate COVID-19 vaccine information, reduce hesitancy and hopefully improve vaccine uptake, particularly in marginalized communities.

Keywords: Coronavirus disease 2019 infection; Coronavirus disease 2019 vaccination; Health disparities; Preventive care; Vaccine hesitancy.

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Conflict of interest statement

Disclosure Dr N. Ezeh and Ms T. Boadi have no disclosures. Dr M.I. Danila: Research grants: NIH (P30 AR072583, P50 AR060772, R01 AI153365, R01 AR065493, R01 AR080784) Pfizer, Radius–sums paid to the Institution. Associate Editor for Arthritis Care and Research. Speaker fees <10k. Hospital for special surgery, UT Southwestern, Cedars Sinai, RheumNow. Dr R. Ramsey-Goldman: Research Grants: NIH (R01AR071091, R01 AR080089, R01 AI170938, P30AR072579, R21AI171491); DOD, United States (W81XWWH2010692); MUSC18-053-8D365; LuCIN subcontract; MP-CPI-21 to 005 OMH (subcontracts with ACR, LFA, University of Alabama); NU58DP0069080100 (subcontract with ACR); PCORI no number (subcontract with University of Alabama, Birmingham), Consulting, Honoraria, Speaking fees (all <10K): State University of New York, Syracuse; Merck; Biogen; Cabaletta; Exagen Diagnostics; Duke University, Ampel Solutions, Clarivate, Upstart Research Consulting, AstraZeneca, Georgetown University. Chair, Collaborative Initiatives Special Committee (COIN) American College of Rheumatology. Dr C.H. Feldman: Research Grants: NIH, United States (1OT2HL161841, 1P30AG064199-03, R01AR080089, 30AR072577, R03AR083661, R01MD019235, R01AR074290), the Bristol Myers Squibb Foundation, United States, the Arthritis Foundation, United States, Brigham and Women’s Hospital Health Equity Innovation Pilot. Consulting: Harvard Pilgrim, OM1, Inc., Bain Capital, LP, the American College of Rheumatology, the Lupus Foundation of America, and the University of Alabama. Speaker honorarium (<10K) from University of Texas Southwestern, University of Alabama at Birmingham, Hospital for Special Surgery, University of Washington. Conference travel reimbursement from RLITE Foundation, the Rheumatology Research Foundation, and EULAR. Associate Editor for Lupus Science and Medicine, Editorial Board for Arthritis Care and Research and Medical-Scientific Advisory Board Member for the Lupus Foundation of America. Member of the American College of Rheumatology Diversity, Equity and Inclusion Committee and the Climate Change Task Force.

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