Background/Purpose: Respiratory Syncytial Virus (RSV) is a leading cause of hospitalization and mortality in older adults and young children, particularly those with chronic illnesses or immunocompromising conditions (IC). Patients with rheumatic diseases (RD) are at increased risk for severe RSV infection. Three RSV vaccines (RSVPreF3, RSVPreF1, and mResvia) were approved by the FDA in May 2023 for individuals aged ≥60 with the Advisory Committee on Immunization Practices (ACIP) recommending vaccination for ≥75 and for individuals ≥60 with chronic IC, including RD and those on immunosuppressive medications. In July 2024, RSVPreF1 was approved for ages 18–59 and RSVPreF3 for ages 50–59 at high risk, with ACIP extending recommendations to these groups in April 2025. Despite these guidelines, surveys indicate that only 16% of eligible individuals receive the RSV vaccine. Uptake is typically lowest in younger adults, minority populations, and those with lower income and educational attainment. Vaccine hesitancy in these groups is frequently cited, yet provider recommendation and patient education are well-documented factors influencing vaccine acceptance. This study assessed RSV vaccination rates among RD patients at our clinic before and after implementing provider-focused education designed to promote in-visit patient education and vaccine administration.

Methods: We queried Epic for patients aged ≥50 with RD or immunosuppressive medication use who received an RSV vaccine at the University Medical Center New Orleans (UMCNO) LSU Safety net Rheumatology Clinic between May 1, 2023, and September 2025. In late March 2025, rheumatology faculty and fellows received an educational presentation on RSV vaccines, including pre- and post-session knowledge assessments. Beginning April 1, 2025, providers were encouraged to spend 1–2 minutes during visits educating eligible patients and recommending same-day vaccination. Key talking points included hospitalization risk, mortality, and risk to grandchildren. If patients required a steroid injection, vaccination was scheduled for a follow-up visit.

Results: Between May 1, 2023, and March 31, 2025, 381 patients aged ≥50 received vaccines at our clinic. Only one patient was vaccinated for RSV in September 2024. Post-education surveys revealed substantial knowledge improvement among providers (Table 1). UMCNO is a safety net system that cares for a majority of minority and disadvantaged people. From April 1 to May 8, 2025, 37 patients were vaccinated for RSV—9 aged 50–59 and 28 aged ≥60 and were of a minority population (Figure 2).

Conclusion: Approximately 70% of patients at the LSU-UMCNO Rheumatology Clinic identify as a minority groups. Following provider education and proactive in-clinic promotion, RSV vaccination rates increased markedly in a short timeframe. These results suggest that vaccine hesitancy in minority populations may be driven more by “Provider Hesitancy”—such as limited time, competing priorities, or lack of awareness—than by patient reluctance. Focused provider engagement and in-clinic vaccine availability appear to be effective strategies to improve uptake in high-risk, diverse populations.

Table 1

Figure 1

Figure 2

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/are-minority-populations-truly-vaccine-hesitant-a-provider-based-approach-to-rsv-vaccine-uptake-suggests-otherwise/