Boards, Advisory Committees, Professional Organizations
Member, American Association for Bronchology and Interventional Pulmonology (2020 - Present)
Member, American Thoracic Society (2019 - Present)
Member, American College of CHEST Physicians (2019 - Present)
Board Certification, American Board of Internal Medicine, Pulmonary Medicine (2021)
Board Certification, American Board of Internal Medicine, Internal Medicine (2019)
Board Certification, American Board of Family Medicine, Family Medicine (2016)
Fellowship, Loma Linda University Medical Center, Pulmonary & Critical Care Medicine (2022)
Residency, Kaiser Permanente Santa Clara Medical Center, CA, Internal Medicine (2019)
Residency, Memorial Hospital of South Bend, IN, Family Medicine (2016)
MD, Saint George's University, Grenada, Medicine (2013)
BA, The University of Chicago, IL, Chemistry (2007)
Original Research: COVID-19 Vaccine Hesitancy Among Southern California Nurses
AMERICAN JOURNAL OF NURSING
2022; 122 (11): 22-31
The purpose of this study was to elucidate characteristics of vaccine-hesitant nurses at two large Southern California medical centers where rates of COVID-19 vaccination were lower than expected.This study is a secondary analysis of nurse participants in a cross-sectional study conducted at the two medical centers. Participants completed an online survey regarding their demographics; work setting and role characteristics; influenza vaccination history; COVID-19 knowledge and beliefs; and personal history of COVID-19 exposure, diagnosis, and disease impact (infection or death) on those closest to them.Of 869 nurse participants, most (78.6%) were vaccinated and 21.4% were unvaccinated; more than half of the unvaccinated participants reported being unwilling to be vaccinated ("vaccine hesitant"). The χ 2 comparisons revealed no significant differences between vaccinated and vaccine-hesitant nurses in terms of education, contact with COVID-19 patients, work environment, or having friends and family impacted by COVID-19. Binary logistic regression showed that nurses who had no history of recent influenza vaccination were 10 times more likely to be vaccine hesitant, those who had inaccurate knowledge about COVID-19 vaccines were seven times more likely to be vaccine hesitant, and younger nurses and those with a prior COVID-19 diagnosis were approximately three times more likely to be vaccine hesitant. Furthermore, 17.3% of all participants were unwilling to recommend COVID-19 vaccination to others.The findings offer a nuanced understanding of vaccine hesitancy among nurses and will be useful to the planning and development of policies, campaigns, and interventions aimed at increasing vaccination rates among nurses. Changing attitudes is essential, and particular attention must be paid to nurses who are unwilling to recommend vaccination to others. Effective interventions are needed.
View details for DOI 10.1097/01.NAJ.0000892492.43587.5f
View details for Web of Science ID 000870054000015
View details for PubMedID 36201394
Racial/Ethnic Variances in COVID-19 Inoculation among Southern California Healthcare Workers
2022; 10 (8)
Healthcare workers (HCWs) from minoritized communities are a critical partner in moving vaccine-hesitant populations toward vaccination, yet a significant number of these HCWs are delaying or deciding against their own COVID-19 vaccinations. Our study aims to provide a more nuanced understanding of vaccine hesitancy among racially and ethnically minoritized HCWs and to describe factors associated with vaccine non-acceptance. Analysis of a sub-sample of racially and ethnically minoritized HCWs (N = 1131), who participated in a cross-sectional study at two large Southern California medical centers, was conducted. Participants completed an online survey consisting of demographics, work setting and clinical role, influenza vaccination history, COVID-19 knowledge, beliefs, personal COVID-19 exposure, diagnosis, and impact on those closest to them. While overall most HCWs were vaccinated (84%), 28% of Black, 19% of Hispanic, and 8% of Asian American HCWs were vaccine-hesitant. Age, education level, occupation, history of COVID-19, and COVID-19 related knowledge were predictive of vaccine hesitancy. We found significant variations in COVID-19 related knowledge and reasons for vaccine hesitancy among Black (governmental mistrust), Hispanic (preference for physiological immunity), and Asian-American HCWs (concern about side effects) who were vaccine-hesitant or not. Our findings highlight racial and ethnic differences in vaccine-hesitancy and barriers to vaccination among HCWs of color. This study indicates the necessity of targeted interventions to reduce vaccine hesitancy that are mindful of the disparities in knowledge and access and differences between and among racial and ethnic groups.
View details for DOI 10.3390/vaccines10081331
View details for Web of Science ID 000845132900001
View details for PubMedID 36016219
View details for PubMedCentralID PMC9414471
Impact of COVID-19 vaccine-associated side effects on health care worker absenteeism and future booster vaccination.
Short-term side effects related to mRNA vaccines against SARS-CoV-2 are frequent and bothersome, with the potential to disrupt work duties and impact future vaccine decision-making.To identify factors more likely to lead to vaccine-associated work disruption, employee absenteeism, and future vaccine reluctance among healthcare workers (HCWs).Side effects related to COVID vaccination: 1- frequently disrupt HCW duties, 2- result in a significant proportion of HCW absenteeism, 3- contribute to uncertainty about future booster vaccination, 4- vary based on certain demographic, socioeconomic, occupational, and vaccine-related factors.Using an anonymous, voluntary electronic survey, we obtained responses from a large, heterogeneous sample of COVID-19-vaccinated HCWs in two healthcare systems in Southern California. Descriptive statistics and regression models were utilized to evaluate the research questions.Among 2,103 vaccinated HCWs, 579 (27.5%) reported that vaccine-related symptoms disrupted their professional responsibilities, and 380 (18.1%) missed work as a result. Independent predictors for absenteeism included experiencing generalized and work-disruptive symptoms, and receiving the Moderna vaccine [OR = 1.77 (95% CI = 1.33 - 2.36), p < 0.001]. Physicians were less likely to miss work due to side effects (6.7% vs 21.2% for all other HCWs, p < 0.001). Independent predictors of reluctance toward future booster vaccination included lower education level, younger age, having received the Moderna vaccine, and missing work due to vaccine-related symptoms.Symptoms related to mRNA vaccinations against SARS-CoV-2 may frequently disrupt work duties, lead to absenteeism, and impact future vaccine decision-making. This may be more common in Moderna recipients and less likely among physicians. Accordingly, health employers should schedule future booster vaccination cycles to minimize loss of work productivity.
View details for DOI 10.1016/j.vaccine.2022.04.046
View details for PubMedID 35465979
View details for PubMedCentralID PMC9013647
Predictors of COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Southern California: Not Just "Anti" vs. "Pro" Vaccine.
2021; 9 (12)
In this study, we evaluated the status of and attitudes toward COVID-19 vaccination of healthcare workers in two major hospital systems (academic and private) in Southern California. Responses were collected via an anonymous and voluntary survey from a total of 2491 participants, including nurses, physicians, other allied health professionals, and administrators. Among the 2491 participants that had been offered the vaccine at the time of the study, 2103 (84%) were vaccinated. The bulk of the participants were middle-aged college-educated White (73%), non-Hispanic women (77%), and nursing was the most represented medical occupation (35%). Political affiliation, education level, and income were shown to be significant factors associated with vaccination status. Our data suggest that the current allocation of healthcare workers into dichotomous groups such as "anti-vaccine vs. pro-vaccine" may be inadequate in accurately tailoring vaccine uptake interventions. We found that healthcare workers that have yet to receive the COVID-19 vaccine likely belong to one of four categories: the misinformed, the undecided, the uninformed, or the unconcerned. This diversity in vaccine hesitancy among healthcare workers highlights the importance of targeted intervention to increase vaccine confidence. Regardless of governmental vaccine mandates, addressing the root causes contributing to vaccine hesitancy continues to be of utmost importance.
View details for DOI 10.3390/vaccines9121428
View details for PubMedID 34960171
View details for PubMedCentralID PMC8706436