Engaging PCPs in COVID-19 vaccine distribution could save ‘thousands of lives’
Primary care physicians are often left out of efforts to bring COVID-19 under control in the United States, but increasing their involvement could have a substantial impact on the pandemic, according to experts.
During an online forum hosted by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Jack Westfall, MD, MPH, the center’s director, said there are about 100,000 to 200,000 primary care clinicians in the U.S.
“If each provides five to 10 COVID-19 vaccines per day, this will be 500,000 to 2 million additional COVID-19 vaccines per day,” Westfall said. “By engaging primary care practices in vaccine dissemination, we can reach herd immunity much earlier, potentially saving thousands of lives.”
In a recent survey of more than 900 primary care clinicians, 89% said they want to use their practice as a COVID-19 vaccination site. However, only 22% have been designated as one by their health system, local hospital or health department. In another survey that included more than 1,000 primary care clinicians, one in four who were willing and able to administer the COVID-19 vaccine said they did not have access to it, and nearly one in three were not a part of state and regional vaccine rollout planning efforts. Both surveys were conducted through a collaboration between the Primary Care Collaborative (PCC), Larry A. Green Center and 3rd Conversation.
Because Americans usually turn to PCPs for vaccination, experts advocated for their involvement in controlling the pandemic.
PCPs “understand what hesitations patients might have and can address them in a real personal way, rather than a paternalistic way,” Darilyn V. Moyer, MD, FACP, FRCP, FIDSA, executive vice president and CEO of ACP, said during an online forum hosted by the PCC. “They also help overcome many obstacles that our patients are facing right now, such as the lack of transportation to vaccine sites, literacy levels and access to broadband.”
A CVS Health survey showed that 64% of Americans trust their PCP to administer the COVID-19 vaccine, and a Kaiser Family Foundation poll found that many Americans consider advice from a physician as the most important factor in determining whether they would get the vaccine.
There are ways to maximize that trust, experts said. PCPs should contact public officials to learn more about how they can assist with efforts in their community, according to Angelica Geter, DrPH, MPH, chief strategy officer at the Black Women's Health Imperative.
“We had primary care providers reach out to the mayor's office to figure out how they could support what was happening at the city level,” Geter said.
Westfall also supported reaching out to government officials and public health leaders.
“I've encouraged [PCPs] to call their public health agency, vaccine manufacturers and elected officials to try to help them get vaccines into primary care,” Westfall told Healio Primary Care. “These people need to learn that PCPs can administer it.”
Reports in The Wall Street Journal and Science indicate that COVID-19 vaccine rollout has been hindered due to a lack of ample freezer space, which is required to store the Pfizer-BioNTech vaccine, Westfall said. However, he noted that other COVID-19 vaccines do not have the same refrigeration requirement.
“Many primary care practices that already give vaccines have appropriate cold storage for the Moderna vaccine,” Westfall said. “More have acquired appropriate cold storage to accommodate the COVID-19 vaccines. The newest vaccine under consideration by the FDA does not require ultra-cold storage and has a long refrigerated shelf life.”
Westfall attributed the lack of PCP involvement in vaccine rollout to policymakers and large corporations.
“When policymakers think of mass immunization, they think of the mass immunizations associated with prior large-scale efforts like smallpox or swine flu,” he said. “Policymakers say, ‘Wow, public health was part of that, so let's have public health do this.’ Then community pharmacies, who are all well‐funded and have a lot of resources to lobby, said, ‘Hey, what about us?’ And lo and behold, the second wave of vaccination distribution policies included them.”
Even if PCPs are currently unable to administer COVID-19 vaccines, J. Lloyd Michener, MD, chair of family medicine and community health at the Duke School of Medicine, said during the forum that they can still be proactive with their patients about vaccination.
“For many folks, especially in our Black and brown communities, the decision to vaccinate against COVID-19 is not a straightforward, simple decision,” Michener said. “This complicated decision needs a trusted adviser to help them think through what they choose to do.”
He encouraged PCPs to “be a community partner.”
“Attend church meetings, visit Hispanic self-help groups,” he said. “The most important thing is to be present, answer questions and help people heal from those historic wounds that go back centuries.”
CVS Health. Shifting trends in vaccine hesitancy. https://payorsolutions.cvshealth.com/sites/default/files/cvs-health-payor-solutions-white-paper-shifting-trends-vaccine-hesitancy.pdf. Accessed February 23, 2021.
KFF. KFF COVID-19 vaccine monitor: In their own words. https://www.kff.org/report-section/kff-covid-19-vaccine-monitor-in-their-own-words-influential-messengers/. Accessed February 23, 2021.
Hopkins JS. COVID-19 vaccine race turns deep freezers into a hot commodity. https://www.wsj.com/articles/covid-19-vaccine-race-turns-deep-freezers-into-a-hot-commodity-11599217201?mod=hp_lead_pos5. Accessed February 25, 2021.
Kaiser J. Temperature concerns could slow the rollout of new coronavirus vaccines. https://www.sciencemag.org/news/2020/11/temperature-concerns-could-slow-rollout-new-coronavirus-vaccines. Accessed February 25, 2021.
Primary Care Collaborative. “February 2021 Webinar: Rolling Up Our Sleeves: The Effort to Vaccinate Americans.” February 23, 2021.
Primary Care Collaborative. “Survey Shows Primary Care is Willing to Distribute Vaccines Widely and Equitably.” Accessed February 24, 2021.
Robert Graham Center. https://www.graham-center.org/content/dam/rgc/documents/publications-reports/reports/PrimaryCareChartbook2021.pdf. Primary care in the United States. Accessed February 24, 2021.
Westfall J, et al.https://deepblue.lib.umich.edu/handle/2027.42/166088. "Primary care's historic role in vaccination and potential role in COVID-19 immunization programs." Accessed February 24, 2021.