567. Reasons for Deferral of COVID-19 Vaccines Among Arab American Healthcare Professionals Living in the United States

Abstract Background The WHO identified the three most common reasons for worldwide vaccine hesitancy to be safety concerns, lack of knowledge and awareness, and religion and cultural issues. There is limited information on this topic among Arab Americans, a rapidly growing demographic in the US. We sought to determine the reasons for deferral of the coronavirus disease 2019 (COVID-19) vaccine amongst Arab American health professionals living in the US. Methods This was a cross-sectional study utilizing an anonymous online survey. The survey was distributed via e-mail to National Arab American Medical Association members and Arab-American Center for Economic and Social Services healthcare employees. Respondents were considered vaccine hesitant if they selected responses other than a willingness to receive the COVID-19 vaccine. Results A total of 4,000 surveys were sent via e-mail from December 28 2020 to January 31 2021. The highest group of respondents were between the ages of 18-29 years and physicians constituted 48% of the respondents. Among 515 respondents, 41.9% (n=216) would receive the vaccine within one month of it becoming available to them, and 30.2% (n=156) had already received a vaccine. Among those who would defer the vaccine, 9.3% (n=48) would receive it within 1-3 months, 5.6% (n=29) within 3-6 months and 6.6% (n=34) after over 6 months or longer. 6.2% (n=32) would not receive the vaccine. The three most commonly reported reasons for deferral of vaccine among 75 vaccine hesitant respondents were: “I am worried about the side effects” (65.3%), “I am worried the vaccine moved through clinical trials too fast (54.7%), and “There is no information about long term side effects of the vaccine” (52%). Data indicate that about a quarter of respondents also expressed distrust of the government and the pharmaceutical industry. The results are summarized in table 1. Conclusion Reasons cited by this sample of Arab Americans for deferring the COVID-19 vaccine mirror more general concerns about vaccine side effects and need for information. Concerns about clinical trial procedures and distrust have become more prevalent with COVID-19. This data can help inform COVID-19 vaccine advocacy efforts among health care providers, and thus could have substantial impact on vaccine attitudes of the general population. Disclosures Marcus Zervos, MD, contrafect (Advisor or Review Panel member)janssen (Grant/Research Support)merck (Grant/Research Support)moderna (Grant/Research Support)pfizer (Grant/Research Support)serono (Grant/Research Support)

. Education encounters and appointments made by community outreach workers and associated vaccinations.

Conclusion.
We successfully implemented a culturally sensitive community outreach model which resulted in higher vaccination rates from at risk ZIP codes when compared to other hospitals. Promotoras encouraged vaccination in native languages, thereby increasing vaccine awareness and appointment faciliation. Barriers to vaccine access remain in these vulnerable communities. This model educated the community via its own members and may help reduce barriers, increase vaccine awareness and vaccination rates.
Disclosures. Background. The WHO identified the three most common reasons for worldwide vaccine hesitancy to be safety concerns, lack of knowledge and awareness, and religion and cultural issues. There is limited information on this topic among Arab Americans, a rapidly growing demographic in the US. We sought to determine the reasons for deferral of the coronavirus disease 2019 (COVID-19) vaccine amongst Arab American health professionals living in the US.
Methods. This was a cross-sectional study utilizing an anonymous online survey. The survey was distributed via e-mail to National Arab American Medical Association members and Arab-American Center for Economic and Social Services healthcare employees. Respondents were considered vaccine hesitant if they selected responses other than a willingness to receive the COVID-19 vaccine.
Results. A total of 4,000 surveys were sent via e-mail from December 28 2020 to January 31 2021. The highest group of respondents were between the ages of 18-29 years and physicians constituted 48% of the respondents. Among 515 respondents, 41.9% (n=216) would receive the vaccine within one month of it becoming available to them, and 30.2% (n=156) had already received a vaccine. Among those who would defer the vaccine, 9.3% (n=48) would receive it within 1-3 months, 5.6% (n=29) within 3-6 months and 6.6% (n=34) after over 6 months or longer. 6.2% (n=32) would not receive the vaccine. The three most commonly reported reasons for deferral of vaccine among 75 vaccine hesitant respondents were: "I am worried about the side effects" (65.3%), "I am worried the vaccine moved through clinical trials too fast (54.7%), and "There is no information about long term side effects of the vaccine" (52%). Data indicate that about a quarter of respondents also expressed distrust of the government and the pharmaceutical industry. The results are summarized in table 1.

Conclusion.
Reasons cited by this sample of Arab Americans for deferring the COVID-19 vaccine mirror more general concerns about vaccine side effects and need for information. Concerns about clinical trial procedures and distrust have become more prevalent with COVID-19. This data can help inform COVID-19 vaccine advocacy efforts among health care providers, and thus could have substantial impact on vaccine attitudes of the general population.
Disclosures. Marcus Zervos, MD, contrafect (Advisor or Review Panel member)janssen (Grant/Research Support)merck (Grant/Research Support)moderna (Grant/Research Support)pfizer (Grant/Research Support)serono (Grant/Research Support) Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with increased morbidity and mortality in immunocompromised individuals, including solid organ transplant recipients (SOTR). Despite being excluded from phase 1-3 SARS-CoV-2 vaccine clinical trials, SOTR were identified as high-risk populations and prioritized for vaccination in public health guidelines. We aimed to evaluate the antibody response to two doses of the BNT162b2 (Pfizer-BioNTech) vaccine in SOTR as compared to healthy controls (HC).

Comparison of Humoral Immune Response to the SARS-CoV-2 BNT162b2 Vaccine Between Solid Organ Transplant Recipients and Healthy Controls
Methods. SOTR and HC scheduled to receive two doses of BNT162b2 vaccine and able to complete required follow-up visits were enrolled. Blood specimens were collected from participants before receiving the first and second doses and 21-42 days after the second dose. Enzyme-linked immunosorbent assay (ELISA) was used to detect immunoglobulin G (IgG) to the SARS-CoV-2 spike receptor-binding domain (RBD). Generalized estimating equations with a working independence correlation structure were used to compare anti-RBD IgG levels between SOTR and HC at each study visit and within each group over time. All models were adjusted for age, sex, and pre-vaccination seroreactivity in the ELISA.
Results. A total of 54 SOTR and 26 HC were enrolled, with mean (SD) ages of 72 (3.6) and 62 (6.7) years, 61% and 35% were male, and 91% and 88% were white, respectively. The most common organ transplant types were kidney (41%) and liver (37%). All SOTR were receiving calcineurin inhibitors. The median time post-transplantation was 7 years. SOTR had markedly lower mean anti-RBD IgG levels when compared to HC with adjusted mean differences of -0.76 (95%CI: [-1.04, -0.47  Anti-SARS-CoV-2 RBD IgG levels in solid organ transplant recipients and healthy controls before receiving the BNT162b2 vaccine (baseline), post-vaccine dose 1, and post-vaccine dose 2.
Conclusion. Our study showed SOTR mounted weaker humoral immune responses than HC to SARS-CoV-2 vaccines. Given a lower response, SOTR should continue to practice social distancing and masking until data on vaccine efficacy are available in this vulnerable population.
Disclosures. Natasha B. Halasa, MD, MPH, Genentech (Other Financial or Material Support, I receive an honorarium for lectures -it's a education grant, supported by genetech)Quidel (Grant/Research Support, Other Financial or Material Support, Donation of supplies/kits)Sanofi (Grant/Research Support, Other Financial or Material Support, HAI/NAI testing) Natasha B. Halasa, MD, MPH, Genentech (Individual(s) Involved: Self): I receive an honorarium for lectures -it's a education grant, supported by genetech, Other Financial or Material Support, Other Financial or Material Support; Sanofi (Individual(s) Involved: Self): Grant/Research Support, Research Grant or Support Background. Although COVID-19 vaccines are very effective, vaccine breakthrough infections have been reported, albeit rarely. When they do occur, people generally have milder COVID-19 illness compared to unvaccinated people. A total of 10,262 (0.01%) SARS-CoV-2 vaccine breakthrough infections had been reported as of April 30, 2021. The objective of this study was to evaluate the effectiveness of COVID-19 vaccines and characterize breakthrough infections in our patient population.

Characterization of COVID-19 Vaccine Breakthrough Infections in Metropolitan Detroit
Methods. This was a retrospective review of all consecutive COVID-19 vaccine breakthrough infections at Henry Ford Health System (HFHS) in metropolitan Detroit, Michigan, from December 17, 2020 to June 7, 2021. Centers for Disease Control (CDC)'s breakthrough infection definition (detection of SARS-CoV-2 RNA or antigen in a respiratory sample ≥14 days after completion all recommended doses of COVID-19 vaccine) was used to identify cases. Vaccination status was extracted from the electronic medical records using Epic™ SlicerDicer.
Results. A total of 228,674 patients, including healthcare workers (HCW), were fully vaccinated in our healthcare system. We evaluate 299 patients for breakthrough infection but only 179 (0.08%) patients met the definition; 108 (60%) were female with median age of 59, 60 (33%) were HCW, and 11 (6%) were immunocompromised. The majority (92%) were asymptomatic (62 or 35%) or had mild/moderate illness (102 or 57%); 14 (8%) had severe or critical illness. The status of one patient was unknown. Of those who were symptomatic, 24 (13%) required hospitalization, and 3 (2%) required intensive unit care. One patient admitted for heart failure exacerbation died unexpectedly prior to being discharged. Nine had previous COVID-19 within 4 months but only one was symptomatic; this likely represented residual shedding in the asymptomatic patients.
Conclusion. COVID-19 vaccine was very effective among our patients and breakthrough infections were rare. Moreover, the vaccine reduced disease severity and mortality. Efforts should aim to increase vaccine uptake.
Disclosures. All Authors: No reported disclosures