NEJM perspective argues for shifting Covid-19 vaccination efforts to primary care setting

May. 11, 2021
graphic: unpacking vaccine hesitancy

As Covid-19 vaccine supply becomes more abundant in the United States, the pace of vaccination has plateaued and even declined. This has been largely attributed to “vaccine hesitancy” rather than issues of access to the vaccine.

In a perspective for the New England Journal of Medicine, CUNY SPH Distinguished Lecturer Scott Ratzan and colleagues say many people who remain unvaccinated may not necessarily be hesitant to get the vaccine, but instead may not have access in a way that works for them. The researchers make a case for administering Covid-19 vaccines in primary care settings where patients are more comfortable and can discuss concerns with a trusted physician, rather than at large vaccination centers. Failing to do so could be a missed opportunity, they say.

The authors discuss results from a survey conducted as part of a unique collaboration between Ascension, Phreesia, the Commonwealth Fund, and CUNY SPH. They surveyed 138,604 people as they checked in online for regular medical visits between March 4 and March 31, 2021 and found that, among the patients who had not yet been vaccinated, many were either receptive or neutral to getting a vaccine. One in six (15%) said they would be more inclined to be vaccinated if their health care provider recommended it to them.

Vaccine messaging is important but not sufficient, Ratzan says.

“We should consider moving away from the ‘vaccine hesitant’ label and realize people may be hesitant about vaccines yet be ready to get vaccinated when the opportunity is communicated to them by trusted sources,” he added. “The data from large-scale surveys of this type can be very helpful to healthcare decision-makers to advance prudent public health policy.”

Ratzan S, Schneider EC, Hatch H, and Joseph Cacchione J. Missing the Point — How Primary Care Can Overcome Covid-19 Vaccine “Hesitancy.” New England Journal of Medicine. May 5, 2021

 

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