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June 27, 2022
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PCP outreach efforts increased COVID-19 vaccine uptake among Black, Latino adults

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Receiving electronic secure messages and mail from primary care physicians increased COVID-19 vaccination rates among older Black and Latino adults, according to researchers.

Tracy Lieu, MD, MPH, the director of the division of research for Kaiser Permanente, and colleagues conducted a randomized clinical trial to analyze how PCP outreach through mailings might impact vaccination rates among older Black and Latino adults — groups that face the highest COVID-19 morbidity rates — “and to compare the effects of culturally tailored and standard PCP messages,” according to the study, published in JAMA Network Open.

PC0622Lieu_Graphic_01_WEB
Data derived from: Lieu, NB, et al. JAMA Netw Open. 2022;doi:10.1001/jamanetworkopen.2022.17004.

The researchers found that outreach from PCPs “led to a significant increase in COVID-19 vaccination rates among Black and Latino older adults who had not responded to earlier, less personalized outreach.”

More than 8,200 people — 56.3% women; 29.4% Black; 70.6% Latino — aged 65 years or older from four Kaiser Permanente Northern California were chosen for the study. Participants were considered eligible if they had not yet received a COVID-19 vaccine but had been sent prior outreach.

The participants were divided into three groups: 2,747 in the standard PCP outreach group, 2,767 in a culturally tailored PCP outreach group and 2,773 in the usual care group, which did not receive any outreach.

The messages included information about how to book a vaccine appointment, the vaccine’s safety and effectiveness, side effects and trust in the vaccine. Culturally tailored PCP messages included all this information while also addressing specific topics such as racial and ethnic disparities, immigration status and cost.

A second outreach was sent to all of those who had not made a vaccination appointment 4 weeks after the initial outreach. This time, it included a postcard with similar content, although the postcards for participants in the culturally tailored group included pictures of older adults in their racial or ethnic group.

Researchers concluded that culturally tailored and standard messages from PCPs prompted significantly higher vaccination rates: 8 weeks after the outreach’s beginning, vaccination rates were 21% in the usual care group, 23% in the standard group and 24% in the culturally tailored group.

Though the difference between standard and culturally tailored outreach was not significant, cumulative incidence curves suggested that both standard outreach and culturally tailored outreach “resulted in a significantly higher rate of vaccination than usual care.”

“These findings lend credence to the suggestion that PCP outreach may particularly benefit Black and Latino adults, who tend to have higher rates of COVID-19 vaccine hesitancy than others,” researchers wrote. “Still, this intervention’s effects were relatively modest.”

Increasing COVID-19 vaccination rates among these groups, researchers said, will likely “require more intensive approaches, including real-time conversations and community-based outreach, as well as behavioral nudges.”

“Once a person has developed openness to being vaccinated, outreach approaches like those studied here may be important catalysts to following through,” they wrote.