A summary of presentations from the weekly Summit partner webinars
April 29, 2021
- Role of Primary Care Providers in COVID-19 Vaccination Efforts
- Discussions from other organizations
Role of Primary Care Providers in COVID-19 Vaccination Efforts
Jason M. Goldman (ACP, ACIP liaison)
Jason M. Goldman, MD, FACP, the American College of Physicians (ACP) and liaison to the Advisory Committee on Immunization Practices (ACIP), gave a presentation discussing ACP COVID-19 vaccine policy, the role of primary care in the COVID-19 vaccine rollout, and COVID-19 resources available from the ACP. Further discussion during the meeting featured invited commentary from other primary care provider organizations.
ACP is the nation’s largest single specialty physician organization, representing over 150,000 internal medicine physicians and the subspecialties throughout the world. When the pandemic hit, the ACP was on the forefront, making sure there were resources available to their members and that their policies were consistent with the CDC and ACIP. The ACP supports the recommendations of the ACIP regarding the COVID-19 vaccines and came out with a policy statement aligning with the distribution and allocation policy of the ACIP.
ACP supports utilizing all appropriately trained, state-licensed clinicians to administer COVID-19 vaccines. Physicians play a role in advising and counseling patients on COVID-19 vaccines, addressing concerns and vaccine hesitancy, and providing post-vaccine counseling. Patients tend to trust their primary care physicians’ recommendations; therefore, they are crucial in addressing fears and concerns, aiding in helping patients understand why vaccines are important, how they’re utilized, how they work, their safety and effectiveness, and making sure patients have confidence in the vaccine process.
Educating patients takes a significant amount of time in addition to routine primary care. Primary care providers have found challenges that come with COVID-19 vaccination in their practices, some of which include payment for vaccine counseling, accessing vaccine, maintaining routine care, addressing the backlog of care due to the pandemic, offering extended hours for vaccinations, and practical challenges like scheduling, documentation, storage and handling requirements, and staffing shortages, among others.
There is state-by-state variability in COVID-19 vaccine distribution and allocation, but primary care physicians are ready to combat the pandemic by any means necessary. Vaccines need to be made available to primary care physicians so that they can vaccinate their patients.
ACP is active in combating vaccine hesitancy with the public and educating primary care providers on how to effectively communicate with their patients. All of ACP’s COVID-19 related resources are publicly-available on the ACP website.
The ACP reviews ACIP’s recommendations and publishes them in the Annals of Internal Medicine, which offers virtual forums that feature a panel of experts providing practical information related to what physicians and other health care professionals need to know about the COVID-19 vaccines.
Dr. Goldman emphasized that prior planning and centralized vaccine scheduling, along with the use of some of the newer vaccines that have one-time dosing and that are more refrigerator-stable for a longer period of time, will help prevent potential vaccine wastage.
In response to a question, Dr. Goldman noted the importance of improving vaccine access for high-risk persons living in areas with a high social vulnerability index (SVI). He added that now that vaccine supplies are more abundant, vaccines should be made available to patients with as little hassle as possible.
Discussions from other organizations
Pamela Carter-Smith – American Academy of Family Physicians (AAFP)
Most family physicians are eager to provide COVID-19 vaccines to their patients, and they are making strong recommendations for vaccination. The AAFP is advocating for physicians to have the vaccine in their practice and to providing resources that aid in combating vaccine hesitancy.
The AAFP has been providing up-to-date information on their webpage containing COVID-related information. Beyond that, members have access to an interest group and numerous town hall activities. The AAFP also has a webpage providing information to physicians that can be given to their patients and another dedicated webpage for patients that includes simple educational materials.
The Robert Graham Center, the research arm of the Academy, is doing weekly surveys for their members to find out information about what’s going on in their practices. Data and feedback is provided in the reports.
Marie-Michele Leger – American Academy of PAs (AAPA)
Physicians who are immunized are better able to recommend the vaccine to their patients, and AAPA has been reaching out to PAs to write op-eds in their local newspapers telling their COVID-19 vaccination story and advocating for vaccination. One such op-ed is from a former board member working in a practice in Colorado who talks about alleviating fears and the reason why he got immunized.
The AAPA encourages their members to have conversations with patients to improve vaccine confidence, and the Academy provides many resources from other organizations on their extensive webpage that can help healthcare providers have more effective conversations with their patients.
One section on the webpage addresses healthcare equity and is designed to help primary care providers in reaching under-represented minorities. This is an important resource as the message needs to effective and community oriented.
Dana Bright – American Academy of Pediatrics (AAP)
In the past year, the AAP has been urging the federal government to support pediatric immunization by strengthening the delivery system. The AAP has been promoting the message that pediatric practices are open, committed, and prepared to continue to see patients during the pandemic. With the expansion of the vaccines, the AAP suggests that the guidance should not be limited to adults; there needs to be broader language so that jurisdictions start to consider the immunization needs of adolescents in their vaccine planning. By including this language now, it will help ensure the infrastructure is in place to roll out vaccines when they are authorized for children and teens, which will be particularly important when they go back to school in the fall.
One way to establish medical offices as COVID-19 vaccination sites is not only to enroll them now as COVID-19 vaccinators, but also to specifically target practices enrolled in the Vaccines for Children (VFC) program, as those practices are already familiar with vaccine storage, handling, and administration. These offices are also well positioned to immunize parents, grandparents, and other members of the family and community while their child is being vaccinated in the office. Pediatric offices will often vaccinate beyond their pediatric patient population when it comes to vaccination against influenza, and this would be a way to get the whole family vaccinated against COVID-19 at once. In addition, offering the COVID-19 vaccine to the child’s caregiver may incentivize parents to bring the child for a routine check-up that they may have missed due to the pandemic.
Providers can share their own experiences and their family’s experiences with the COVID-19 vaccine to connect with patients and parents.
Parents surveyed through AAP’s Healthy Children website suggest concerns with the COVID-19 vaccine mirror those of routine vaccines, with a heavy concern about potential long term effects and the speed with which these vaccines were developed. The AAP offers many resources for parents on their Healthy Children website.
Ms. Bright mentioned that there is movement on the part of Pfizer to have doses provided in smaller quantities, which would allow pediatricians to be able to manage, store, and administer the vaccine without as much waste. Providers are eager to vaccinate, and many are purchasing subzero freezers so that they will be ready once vaccines will be offered to younger children.
Sarah Carroll – American College of Obstetricians and Gynecologists (ACOG)
OB-GYNs tend to see women regularly throughout their reproductive years, including during pregnancy, which makes them one of the biggest resources for providing vaccine education to women. This allows for another opportunity beyond primary care physicians for conversations about vaccination with COVID-19 vaccine and other vaccinations important in adulthood and pregnancy, such as influenza and Tdap.
ACOG is encouraging its members to become COVID-19 vaccinators. They are finding that clinician testimonials explaining why they made their choice to get vaccinated during pregnancy or while breastfeeding are a great way to encourage vaccine confidence in their patients. Data shows that people are showing up as couples to get vaccinated; women tend to be a driving force in getting their families vaccinated and are often the healthcare navigators for their families. OB-GYNs are a great resource for women to make the choice to get themselves and their families vaccinated.
ACOG requests that state health departments support the ability of OB-GYNs to provide COVID-19 vaccines to their patients.
Tara Jatlaoui – Adult Immunization Lead at CDC
CDC is working to improve the distribution of the COVID-19 vaccine to primary care providers, with a heavy focus on vaccine equity and ensuring confidence in socially vulnerable communities. The CDC is asking jurisdictions to prioritize these areas of need so that citizens of the community are able to get the trusted messages they need to hear from primary care providers, as many are more willing to get the vaccine from their doctor than in another setting.
Recommendations are in place asking primary care providers to work within their patient network in outreach and education to address hesitancy, build confidence, and provide access to the COVID-19 vaccine. When capable, primary care physicians need to work within their communities as trusted resources to their community members who are more willing to get the vaccine if they’re hearing the message from someone they trust in the community.
Carolyn Bridges added that there are a lot of evidence-based practices for improving uptake of the vaccine, including reminder-recall, which can be helpful for healthcare providers to remind their patients about vaccinations.
Becky Snead – National Alliance of State Pharmacy Associations (NASPA)
Pharmacists have made a tremendous contribution to the COVID-19 vaccination effort, not only by vaccinating, but also by offering education for those who are concerned about the side effects. They may also play a role in recommending patients visit their primary care physicians for additional services. Ms. Snead stressed that getting people vaccinated has been all hands on deck effort. We are all on the same team and we need to make it easy to get all patients vaccinated.
L.J Tan (IAC)
The Summit will conduct a virtual meeting, Maintaining Influenza Prevention During the Ongoing COVID-19 Pandemic, on May 20 from 2–4:30 pm ET. This webinar will be held in place of the usual in-person Summit meeting held each spring. The agenda will include updates on influenza surveillance, influenza vaccine uptake, communications planning for the upcoming season, and presentations from vaccine manufacturers on their estimated vaccine supply for the 2021–22 influenza season. Registration information is available on the Summit website.