The following article is a part of conference coverage from the American Academy of PAs 2021 Conference (AAPA 2021), held virtually from May 23 to May 26, 2021. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading PAs. Check back for more from AAPA 2021


The COVID-19 pandemic laid bare the disparities in health care — marginalized communities were infected by the disease at higher rates and faced the most difficulty getting treatment. Some of the same barriers may affect vaccine acceptance and rates of vaccinations. 

To find out which specific barriers might prevent a marginalized group from wanting the COVID-19 vaccine, Connor Lampasona, a PA student at Wagner College, and colleagues studied the Medicaid population in Staten Island. The team presented their results in a poster session at the American Academy of PAs 2021 Conference (AAPA 2021).

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“We decided to focus on Medicaid recipients because we felt it necessary to examine a population that faces a plethora of barriers that could potentially hinder them from accepting the vaccine [eg, lack of vaccine knowledge, lack of vaccine convenience, and lack of trust in health care],” Lampasona said. “We want to increase accessibility for all marginalized individuals like Medicaid recipients who are facing barriers to acceptance of the vaccines.”

The team partnered with Staten Island Performing Provider System (SI PPS) to distribute an electronic survey to Medicaid recipients to identify the rate of vaccine acceptance. Of 346 respondents:

  • 50% said they would get the vaccine
  • 21% said they would not get the vaccine
  • 29% said they were not sure                                                           

Overall, survey respondents had an appropriate understanding of the SARS-CoV-2 virus and knew how to prevent contracting the disease. Nearly all of the respondents (94%) correctly answered the question, “What steps can a person take to prevent themselves from getting COVID-19?”

The main barriers to vaccine acceptance were a distrust in health care providers to educate them about the vaccine, fear of its connections to autism and other diseases, and altruism.  

“A lot of people thought that due to unequal access, they would want to give their chance of getting the vaccine to others more at risk,” Lampasona said. “We also found that people needed more information about the vaccine before getting it. We want to give more access to those patients to give them that information.”

Time and transportation to vaccine sites were also challenging for the respondents, Lampasona added. Conversely, participants who had received a flu shot were approximately 5 times more likely to accept the COVID-19 vaccine.

“We want to make sure these patients are able to feel comfortable with their health care providers and trust them to educate them about vaccines and all other necessary topics,” Lampasona said. Further investigation on how to provide transportation to vaccine sites is also needed, he added.

Visit Clinical Advisor’s meetings section for complete coverage of AAPA 2021.


Azer RR, Bracker SK, D’Acunto DM, et al. Barriers to acceptance of the COVID-19 vaccine: a study of Staten Islanders on Medicaid.  Poster presented at: American Academy of PAs Conference; May 23-26, 2021. Poster #157.