Data suggest PCPs ‘play critical role in ensuring vaccine acceptance’

Counties in the United States with the highest number of primary care physicians also had the highest COVID-19 vaccination rates, a cross-sectional study showed.

“Survey data suggest that a substantial portion of the unvaccinated population would be willing to get vaccinated if they had greater access to accurate information and receive encouragement from a trusted source,” Chun-Han Lo, MD, MPH, a postdoctoral research fellow at Massachusetts General Hospital, and colleagues wrote in JAMA Network Open. “Primary care physicians can reach such individuals through direct engagement or alliances with community health workers, community centers and mass-vaccination sites.”

The researchers compared PCP rates and COVID-19 vaccination rates at the county (or similar region) level across the United States. The analysis excluded eight counties in California, where the population was less than 20,000, and six states — Alaska, Georgia, Hawaii, Vermont, Virginia and West Virginia — that had insufficient data. The researchers adjusted their study model based on demographic factors, whether the county was in an urban area and its socioeconomic standing.

Overall, 87.2% of U.S. counties were included in the study. Lo and colleagues found that the largest concentration of PCPs was in the Northeast, Florida and many counties in the Midwest and West. That finding “roughly corresponded to the distribution of counties with higher COVID-19 vaccination rates,” the researchers wrote. After adjusting the model, counties in regions with the highest number of PCPs per 100,000 people had a 5.5% higher COVID-19 vaccination rate than counties in regions with the lowest numbers of PCPs (95% CI, 2.6-8.4).

In addition, for each 10 additional PCPs per 100,000 people, the vaccination rate increased by 0.3% (95% CI, 0.2-0.4). Stratified analyses revealed similar associations in rural areas or locations with fewer than 2,500 residents (0.5% higher vaccination rate; 95% CI, 0.3-0.7).

“Our findings suggest that PCPs play a critical role in ensuring vaccine acceptance, especially in resource-limited and vaccine-hesitant regions, potentially through counseling and building local community trust and partnerships before they had access to vaccines,” Lo and colleagues wrote.

They added that limitations to the study include the accuracy of vaccination administration data and the possibility of incalculable variables such as vaccine mandates.

“Nevertheless, this study’s results provide support for expanding COVID-19 vaccine distribution to PCPs,” Lo and colleagues wrote. “Although fully incorporating PCPs into vaccination campaigns poses many challenges, PCPs may leverage their role as trusted messengers of scientific knowledge and educate communities about the importance of vaccination.”