What Role did Primary Care have in the COVID-19 Vaccine Rollout?: A Rapid Review of 9 Jurisdictions

Context: There are significant concerns about vaccine hesitancy and the equitable distribution of the COVID-19 vaccines. The inclusion of first-contact primary care providers in the vaccine distribution is one approach that can increase vaccine confidence and adoption.

Objective: The aim of this study was to examine the experience of nine global jurisdictions that engaged primary care providers to administer COVID-19 vaccines during the pandemic.

Study Design and Analysis: A rapid review methodology was adopted. Searches and analyses took place from May 2021 to July 2021. Inclusion criteria were: previously identified jurisdictions focused on COVID-19, referred to the role of primary care, published from January 2020 to July 2021 and in English. Data were extracted based upon study characteristics (e.g., study design) and research questions (e.g., role of primary care, vaccine strategy change over time).

Dataset: MEDLINE, CINAHL, the Cochrane Library, SCOPUS and PsychINFO, Google, and the websites of national health departments.

Population Studied: Australia, Hong Kong, Germany, France, Israel, Singapore, Spain, United States, and the United Kingdom.

Intervention/Instrument: COVID-19 vaccine distribution strategy.

Outcome Measures: Primary care involvement.

Results: Sixty-two documents met the inclusion criteria. This review found that the vaccine distribution approach started at hospitals in almost all jurisdictions. In some jurisdictions, primary care providers were engaged at the beginning, and the majority included primary care providers over time. Vaccine hesitancy was not explicitly considered in the selection of vaccine distribution approaches. Support to primary care providers was provided through education and training, financial incentives, and organizational support. The barriers to the rollout of the vaccines included individual, organizational and system-level factors. Empirical evidence is lacking on the impact of a primary care-led vaccine distribution approach on vaccine hesitancy, adoption, and equity.

Conclusions: Globally, the primary care workforce had an essential role in administering vaccines during the COVID-19 pandemic. Future vaccine distribution approaches need to be informed by evaluating vaccine distribution approaches and their impact on patient and population outcomes.