Vaccinating millions of Americans against the COVID-19 virus is proving to be a complicated process already plagued with many setbacks.
But there's already a ready-made vaccine distribution system that can be tapped into to accelerate the rollout, some experts say: primary care doctors.
Primary care doctors provide nearly half of all vaccines in the U.S. and their role may help assure successful delivery of the COVID-19 vaccines to communities across the nation, including rural and remote communities, according to a preprint study published in the Annals of Family Medicine.
"Bottom line, if we engage and activate the ready-made primary care practices, we can accelerate COVID-19 vaccine distribution and reach herd immunity through immunization sooner," said John Westfall, M.D., a co-author of the study and director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care.
"Vaccine manufacturers already know who orders vaccines and could deliver vaccines to those same primary care offices. Medicare knows who provides COVID-19 to Medicare beneficiaries and actually know how many beneficiaries get their vaccines from these practices. They could ship out that number of vaccines to each primary care practice for their seniors. Or do so in waves," Westfall said.
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There’s growing frustration among medical groups about being shut out of the vaccine distribution process with primary care docs even missing out on getting the vaccines themselves.
The Medical Group Management Association (MGMA) is urging the Biden administration to include medical group practices in COVID-19 vaccine distribution strategies moving forward. A survey reflecting responses from 403 medical group practices showed 85% of independent practices actively seeking the COVID-19 vaccine for their patients received some as of Jan. 21-24. Nearly half (45%) of hospital- or health system-owned practices seeking vaccines still hadn't gotten any. Meanwhile, the majority of practices that have gotten the vaccine (54%) say they only received enough to vaccinate 1% or less of their patients.
The COVID-19 pandemic recovery will require a broad and coordinated effort for infection testing, immunity determination, and vaccination, the study authors said.
The study evaluated the delivery of vaccinations, using 2017 Medicare Part B Fee-For-Service data and the 2013-2017 Medical Expenditure Panel Survey at the service, physician, and visit level. The data shows that primary care physicians have played a crucial role in delivery of vaccinations to the U.S. population, including the elderly, between 2012-2017.
Overall, PCPs provided the most vaccinations (46%), followed closely by mass immunizers (45%), then nurse practitioners/physician assistants (5%). There were clusters of counties that had over 50% of vaccinations provided by PCPs throughout states such as Louisiana, Pennsylvania and Massachusetts, the study found.
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In addition to physically administering vaccinations, PCPs can provide clinical and personal support to enable patients to understand their current COVID-19 immunologic status, how that may impact their vaccine decisions, and to counter vaccine hesitancy and misinformation, the study said.
There continues to be a high level of distrust in the COVID-19 vaccine among some populations. The new vaccines may face more vaccine hesitancy, misinformation, and refusal than other vaccines, the study said.
It's important to leverage the trusted relationship that primary care physicians have with patients when distributing the COVID-19 vaccine.
"Primary care practices may play an even more important role in vaccine counseling, building local community trust, and serving as a source of scientific knowledge about the COVID-19 vaccine," the study authors said.
Given its historic role in immunization counseling and vaccine delivery, primary care, in concert with public health agencies and community health organizations, is essential for immediate and sustainable population health efforts to address COVID-19 recovery, the study said.