Q&A: PCPs still ready to help with COVID-19 vaccine rollout, but excluded from efforts
New data indicate that clinicians and patients want primary care to be more involved in the COVID-19 vaccine rollout process, but there is still a lack of coordination between clinics and health departments.
A survey of 765 primary care clinicians from 48 states and Guam conducted through a collaboration between the Primary Care Collaborative and Larry A. Green Center in mid-March revealed that 74% were willing to provide the COVID-19 vaccine to their patients, and 49% were “ready and able” to do so. However, 54% said their local health department had not actively engaged with them to distribute the vaccine. In addition, 46% of the respondents said their patients have called the clinic “demanding to be vaccinated,” according to the report.
Earlier this year, in a survey of more than 900 primary care clinicians, 89% said they want to use their practice as a COVID-19 vaccination site but only 22% were designated as one by their health system, local hospital or health department.
In a recent statement, the Pennsylvania Medical Society said primary care physicians who want to administer the COVID-19 vaccine face “a slew of hurdles,” the most recent being an amendment to the PREP Act that expands vaccinators to include veterinarians and dentists.
In an interview with Healio Primary Care, Michael DellaVecchia, MD, PhD, FACS, president of the Pennsylvania Medical Society and physician at Thomas University Hospital and Main Line Health in southeastern Pennsylvania, discussed possible reasons for the continued lack of primary care involvement in COVID-19 vaccine efforts, the implications of this, and more.
Healio Primary Care: What is preventing PCPs from administering the COVID-19 vaccine? Why do you think they have such a small role in vaccine rollout?
DellaVecchia: The Pennsylvania Department of Health thinks until it gets a handle on how these vaccines are best distributed, it is best to limit vaccine distribution to a few select groups. There may be some political influences in that.
Our contention is that primary care is prepared and should be part of the vaccine distribution now. Vaccine hesitancy often exists in the inner cities. These patients also often do not have transportation to a vaccine distribution center and do not have the resources to log on a computer database to schedule appointments. PCPs can intervene and alleviate these problems.
Healio Primary Care: How does expanding COVID-19 vaccinators to include veterinarians and dentists further complicate the issue?
DellaVecchia: There is a difference in vaccinating a puppy as opposed to a child. This decision to include veterinarians and dentists in the vaccine process complicates the issue further because this decision leaves out experts at delivering vaccines to people.
Healio Primary Care: Is the lack of involvement from PCPs slowing efforts to bring COVID-19 under control? If so, how much of an impact is this having on the pandemic?
DellaVecchia: We know that the more people we inoculate, the better it is for the people.
We are also seeing that people who have been confined for a year are having a lot of economic problems, mental health issues and other types of problems. It would definitely be better to be back to normal sooner rather than later.
PCPs have not only been administering vaccines for generations, they know the whole patient, not just the COVID aspect, and what COVID has done to their patients and society. Our patients tell us they would love to see this vaccine in the hands of primary care, and we would like to do that for them.
Healio Primary Care: What needs to change at the local, state and federal level to increase PCP involvement? What resources will they need to successfully administer the vaccine to their patients?
DellaVecchia: PCPs are duly ready to be involved. It's just a matter of getting the state to get the vaccine down to them. And that's what we're trying to do.
Here in Pennsylvania, we have a list of retired physicians who are willing and able, so long as there is malpractice insurance coverage for providing the vaccine, who at a moment's notice will show up to administer it. But the current administration at the state level has been very hesitant on providing this insurance.
Initially, it may have been a little difficult for some PCPs because of the need for cryopreservation of the Moderna and Pfizer/BioNTech vaccines. But some other PCPs stepped up to the plate and found ways to cryopreserve the vaccine. And now, of course, there is the Johnson & Johnson vaccine, which does not demand cryopreservation.
Healio Primary Care: When do you predict PCPs will have a greater role in COVID-19 vaccination?
DellaVecchia: The timetable is not up to me. I just say there’s a job that has to be done and let’s do what it takes to get it done.
References:
Pennsylvania Medical Society. Physicians face sea of obstacles in vaccinating patients. https://www.pamedsoc.org/home/pamed-news/articles/press-statement-covid-vaccine-hurdles. Accessed March 30, 2021.
Primary Care Collaborative. https://www.pcpcc.org/2021/03/29/survey-shows-patients-and-clinicians-want-primary-care-more-involved-mass-vaccination. Survey shows patients and clinicians want primary care more involved in mass vaccination efforts. Accessed March 30, 2021.