Association of Primary Care Physicians Per Capita With COVID-19 Vaccination Rates Among US Counties

Lo, Chun‐Han; Chiu, Leonard; Qian, Anna; Khan, Muhammad Zarrar; Al-Hassan, H.; Duval, A.J.; Chan, Andrew T.

doi:10.1001/jamanetworkopen.2021.47920

Cited by 24 publications

(24 citation statements)

References 4 publications

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“…Lower uptake of both initial vaccination and boosters by the uninsured suggests that healthcare access affects use of preventive services, even when free. Lack of primary care may contribute; both county-level primary-care-physician density 5 and receipt of a recommendation for vaccination from a healthcare provider 6 have been associated with higher initial COVID-19 vaccine uptake rate. However, other factors may play a role.…”

Section: Discussionmentioning

confidence: 99%

Disparities in COVID-19 Vaccine Booster Uptake in the USA: December 2021–February 2022

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Disparities in COVID-19 Vaccine Booster Uptake in the USA: December 2021–February 2022

et al. 2022

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“…However, the potential of massive vaccination to tackle the pandemic has been hampered by substantial heterogeneity in vaccination coverage and uptake. Some areas of the US have achieved full vaccination (people who have received two doses of the mRNA Pfizer-BioNTech or Moderna vaccines, or a single dose of the Janssen/Johnson & Johnson vaccine) in more than 80% of their population whereas other areas have less than 40% ( 7 , 8 ). Vaccination coverage influences the spatial dispersion of the epidemic.…”

Section: Introductionmentioning

confidence: 99%

Association Between Vaccination Coverage Disparity and the Dynamics of the COVID-19 Delta and Omicron Waves in the US

Cuadros

Moreno

Musuka³

et al. 2022

Front. Med.

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ObjectiveThe US recently suffered the fourth and most severe wave of the COVID-19 pandemic. This wave was driven by the SARS-CoV-2 Omicron, a highly transmissible variant that infected even vaccinated people. Vaccination coverage disparities have played an important role in shaping the epidemic dynamics. Analyzing the epidemiological impact of this uneven vaccination coverage is essential to understand local differences in the spread and outcomes of the Omicron wave. Therefore, the objective of this study was to quantify the impact of vaccination coverage disparity in the US in the dynamics of the COVID-19 pandemic during the third and fourth waves of the pandemic driven by the Delta and Omicron variants.MethodsThis cross-sectional study used COVID-19 cases, deaths, and vaccination coverage from 2,417 counties. The main outcomes of the study were new COVID-19 cases (incidence rate per 100,000 people) and new COVID-19 related deaths (mortality rate per 100,000 people) at county level and the main exposure variable was COVID-19 vaccination rate at county level. Geospatial and data visualization analyses were used to estimate the association between vaccination rate and COVID-19 incidence and mortality rates for the Delta and Omicron waves.ResultsDuring the Omicron wave, areas with high vaccination rates (>60%) experienced 1.4 (95% confidence interval [CI] 1.3–1.7) times higher COVID-19 incidence rate compared to areas with low vaccination rates (<40%). However, mortality rate was 1.6 (95% CI 1.5–1.7) higher in these low-vaccinated areas compared to areas with vaccination rates higher than 60%. As a result, areas with low vaccination rate had a 2.2 (95% CI 2.1–2.2) times higher case-fatality ratio. Geospatial clustering analysis showed a more defined spatial structure during the Delta wave with clusters with low vaccination rates and high incidence and mortality located in southern states.ConclusionsDespite the emergence of new virus variants with differential transmission potential, the protective effect of vaccines keeps generating marked differences in the distribution of critical health outcomes, with low vaccinated areas having the largest COVID-19 related mortality during the Delta and Omicron waves in the US. Vulnerable communities residing in low vaccinated areas, which are mostly rural, are suffering the highest burden of the COVID-19 pandemic during the vaccination era.

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“…One of the most important determinants of whether someone will receive a vaccine is having a source of regular medical care, 3 so it is unsurprising that a higher number of primary care physicians per capita is associated with higher rates of COVID-19 vaccination. 4 The Author affiliations and article information are listed at the end of this article. shortcomings of the national vaccination efforts are particularly troubling when it is noted that COVID-19 vaccination rates were even lower in more vulnerable areas than in less vulnerable areas, as a modern manifestation of the now 50-year-old "inverse care law," whereby those who need care the most are least likely to receive it.…”

Section: Need For a Primary Care Infrastructurementioning

confidence: 99%

“…Although the development of effective vaccines in a remarkably short time span represents a triumph of science, the shortfall in vaccination rates in the US compared with other high-income countries should highlight that primary care physicians play an irreplaceable role in delivering essential preventive services, including vaccinations. One of the most important determinants of whether someone will receive a vaccine is having a source of regular medical care, so it is unsurprising that a higher number of primary care physicians per capita is associated with higher rates of COVID-19 vaccination . The shortcomings of the national vaccination efforts are particularly troubling when it is noted that COVID-19 vaccination rates were even lower in more vulnerable areas than in less vulnerable areas, as a modern manifestation of the now 50-year-old “inverse care law,” whereby those who need care the most are least likely to receive it …”

Section: Need For a Primary Care Infrastructurementioning

confidence: 99%

The Post–COVID-19 Case for Primary Care

Galea

2022

JAMA Health Forum

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Much has been written and discussed about challenges faced by the US health care system, with most of it justifiably concerning the payment system for medical services, and how that leaves an unconscionably large proportion of US residents uninsured or underinsured for quality care.Although payment systems are undoubtedly a challenge and merit substantial conversation, the structure of US health care delivery also leaves much to be desired.Central to that problem is the paucity of primary care physicians in the US. The approximately 200 000 active primary care physicians in the US represent about 30% of all active physicians, down from 32% about 10 years ago. About 28% of men and 17% of women report they do not have a primary care physician. The Council on Graduate Medical Education recommended an increase in

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Association of Primary Care Physicians Per Capita With COVID-19 Vaccination Rates Among US Counties

Abstract: e Based on greatest to least vote share, includes

Cited by 24 publications

References 4 publications

Disparities in COVID-19 Vaccine Booster Uptake in the USA: December 2021–February 2022

Disparities in COVID-19 Vaccine Booster Uptake in the USA: December 2021–February 2022

Association Between Vaccination Coverage Disparity and the Dynamics of the COVID-19 Delta and Omicron Waves in the US

The Post–COVID-19 Case for Primary Care

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