Primary Care’s Historic Role in Vaccination and Potential Role in COVID-19 Immunization Programs

Abstract

PURPOSE Coronavirus disease 2019 (COVID-19) pandemic recovery will require a broad and coordinated effort for infection testing, immunity determination, and vaccination. With the advent of several COVID-19 vaccines, the dissemination and delivery of COVID-19 immunization across the nation is of concern. Previous immunization delivery patterns may reveal important components of a comprehensive and sustainable effort to immunize everyone in the nation. METHODSThe delivery of vaccinations were enumerated by provider type using 2017 Medicare Part B Fee-For-Service data and the 2013-2017 Medical Expenditure Panel Survey. The delivery of these services was examined at the service, physician, and visit level. RESULTSIn 2017 Medicare Part B Fee-For-Service, primary care physicians provided the largest share of services for vaccinations (46%), followed closely by mass immunizers (45%), then nurse practitioners/physician assistants (NP/PAs) (5%). The Medical Expenditure Panel Survey showed that primary care physicians provided most clinical visits for vaccination (54% of all visits).CONCLUSIONS Primary care physicians have played a crucial role in delivery of vaccinations to the US population, including the elderly, between 2012-2017. These findings indicate primary care practices may be a crucial element of vaccine counseling and delivery in the upcoming COVID-19 recovery and immunization efforts in the United States.

Perspectives of primary care physicians on acceptance and barriers to COVID-19 vaccination

“…PCPs and other healthcare professionals have been identified as trustworthy sources of COVID-19 information 7 and may be the best situated group to counter misinformation that could dissuade patients from accepting vaccination. A 2021 study of 5 years of Medicare data (2012–2017) found that PCPs provide the most vaccines in the USA, 35 which supports that they are both experienced and well equipped to provide COVID-19 vaccinations, immunisation counselling and ongoing clinical guidance to patients. However, others have noted that COVID-19 vaccinations in the USA have mainly been occurring outside of primary care settings, and thus, to encourage the vaccine hesitant to receive the COVID-19 vaccine, vaccination efforts may need to be shifted to primary care in order to take advantage of the trust the PCPs have built with their patients.…”

Receptiveness of American adults to COVID-19 vaccine boosters: A survey analysis

“…This may include an emphasis on more localized sources, such as primary care physicians or community health leaders. Evidence suggests that primary care physicians are a critical component of not only mass vaccination campaigns, but also individual health messaging about the importance of vaccination [ 9 ]. Such trust would not be uncommon for localized information.…”

Medical knowledge about COVID-19 is travelling at the speed of mistrust: why this is relevant to primary care

“…Primary care physicians (PCPs) are often the first point of contact for patients in the healthcare system who cultivate longitudinal relationships, are the most trusted source on COVID-19 and other vaccines, and have historically been involved in immunization counselling and vaccine delivery. 6 This position enables PCPs to serve as a unique resource for patients and caregivers, in not only helping to address misinformation 7 related to the pandemic and vaccine hesitancy, but also to be involved in the public health and preventive responses, which are generally composed of subspecialist experts of various scientific technical committees, with little to no primary care representation. 8 This preventive response entails providing accurate information and physician-led education to patients such as recognizing warning signs of COVID-19, importance of self-assessment, timely triage through risk stratification, concerns about vaccine safety and follow-up.…”