Evidence map›Paper›PMID 40432069›Full record

ArticleVaccines2025

Emergency Medical Services Clinicians and COVID-19 Booster Behavior-A Cross-Sectional National Evaluation.

Gregory Muller, Christopher B Gage, Jonathan R Powell, Sarah R MacEwan, Laura J Rush, Eben Kenah, Gennaro Di Tosto, Ann Scheck McAlearney, Ashish R Panchal

Abstract read
In one paragraph

Article in Vaccines, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Gregory MullerSection of Prehospital and Disaster Medicine, Department of Emergency Medicine, Stanford University, Stanford, CA 94305, USA.
Christopher B GageNational Registry of Emergency Medical Technicians, Columbus, OH 43229, USA.ORCID 0000-0001-5150-0740
Jonathan R PowellNational Registry of Emergency Medical Technicians, Columbus, OH 43229, USA.ORCID 0000-0003-3443-0247
Sarah R MacEwanDivision of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA.ORCID 0000-0002-4365-6232
Laura J RushThe Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA.ORCID 0000-0003-3859-6885
Eben KenahDivision of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA.
Gennaro Di TostoThe Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA.ORCID 0000-0003-2402-1925
Ann Scheck McAlearneyThe Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA.ORCID 0000-0001-9107-5419
Ashish R PanchalNational Registry of Emergency Medical Technicians, Columbus, OH 43229, USA.ORCID 0000-0001-7382-982X

Funding

NCI NIH HHS CA260582
6 · The paper itself

Abstract

BACKGROUND/

objectivesEmergency Medical Services (EMS) clinicians in the US have high COVID-19 vaccine hesitancy rates and often do not receive primary vaccinations or subsequent boosters. The extent of booster attrition following initial vaccination and first booster dose in EMS clinicians is unknown. Our objective was to evaluate the prevalence and drivers of COVID-19 booster attrition in EMS clinicians. We hypothesized that booster attrition is common among EMS clinicians and associated with various EMS characteristics.

methodsThis study was a cross-sectional analysis of nationally certified civilian EMS clinicians aged 18-85 years old. An electronic survey was distributed, which included an evaluation of vaccination status, booster acceptance, willingness to receive future boosters, perceived risk of contracting COVID-19 from the Understanding America Survey (8 items), and mistrust of healthcare organizations using the Medical Mistrust Index (MMI) (7 items). These data were combined with demographic and work-related characteristics from the National Registry of EMTs dataset. A multivariable logistic regression model (OR, 95% CI) was used to describe booster attrition associations between demographics, work-related characteristics, perceived risk, and medical mistrust.

resultsA total of 1902 respondents met initial inclusion criteria. Within this group, 78% were COVID-19 vaccinated, and an additional 65% received a booster. Of these, 37% reported not planning to receive any other booster treatments following the first booster. Primary reasons for not continuing with subsequent boosters include confusion among experts on efficacy (59%), severe side effects (38%), the belief that COVID-19 is not a threat (26%), the belief in natural immunity (25%), and the belief that boosters are not required (23%). Odds of planning to receive another booster increased with receiving a flu vaccine (5.03, 3.08-8.22) and urban environment (1.96, 1.19-3.24, referent rural). In comparison, the odds of planning to receive another booster were lower for paramedics (0.56, 0.38-0.83, referent EMT) and fire agencies (0.53, 0.31-0.89, referent hospital). As the perceived risk of COVID-19 and medical mistrust decrease, the odds of planning to receive another booster increase (perceived risk: 1.98, 1.41-2.78; trust: 4.12, 3.21-5.28).

conclusionsThe rate of booster attrition following receipt of one booster is high, at 37%. While there are associations with EMS demographic and workforce characteristics, further exploration is necessary to define the drivers and potential consequences of high booster attrition in the EMS clinician community.

Indexed as

COVID-19emergency medical services (EMS)workforce readiness

Identifiers

PMID40432069
PMCPMC12115428

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.