Special Report: Improving Conversations with COVID-19 Vaccine Hesitant Patients: Action research to support family physicians
Myles Leslie, Raad Fadaak, Nicole Pinto
Societal and operational challenges familiar to family medicine have been given new form and urgency by the COVID-19 pandemic. Vaccination delivery and efforts to counter vaccine hesitancy have become focal issues for family medicine teams. Conducting action research, our team developed an interactive web-based Guide to improve clinical conversations around a broad range of vaccine hesitancies as presented by patients. The Guide was co-designed with family physicians in a process that included validation interviews and role-play interviews. The validation interviews sought to understand the pragmatic realities of vaccine hesitancy in family medicine clinical practice relative to relevant psychological theories. The role-play interviews drew out conversational strategies and advice from family physicians. The principles of Motivational Interviewing - an evidence-based approach to vaccine hesitancy conversations that supplements information deficit approaches - were then used to co-design the content and presentation of the Guide. User counts, stakeholder engagement, and web-based analytics indicate the Guide is being used extensively by family physicians. Formal evaluation of the Guide is presently underway. 1 Oct, 2021. Non-refereed, under review. Permanent URL: https://hdl.handle.net/2027.42/170143
Innovation in Primary Care: Addressing COVID-19 Immunization Disparities through Targeted Primary Care Outreach
Emmeline Ha, Grace Yu, Bridget Harrison
The authors describe an innovative approach to increasing COVID-19 vaccination uptake by a primary care provider-led targeted outreach protocol using zip codes, EHR data and phone canvassing. Preliminary findings show that primary care has a critical role in increasing access, equity, and patient uptake of COVID-19 vaccines. 17 Aug, 2021. Under review, online-collection only. Permanent URL: http://hdl.handle.net/2027.42/168565
Special Report: Planning and implementing COVID-19 mass vaccination clinics
Shima Shakory, Azza Eissa, Tara Kiran and Andrew D. Pinto
St. Michael's Hospital
The COVID-19 pandemic is an unprecedented global public health crisis. Mass vaccination with safe and effective vaccines to achieve herd immunity requires a whole-of-society approach. Primary care has played a key role in those countries that have succeeded in rapidly vaccinating a large proportion of their populations, particularly those most at risk. In this special report we synthesize existing guidelines and peer-reviewed studies to provide family physicians with practical guidance on planning and implementing COVID-19 mass immunization clinics. PubMed, Ovid, MEDLINE, Epub Ahead of Print, Embase and Google Scholar were used to search for relevant literature using keywords, including “COVID-19”, “mass vaccination”, “campaign”, “standard” and “best practice”. We also identified and analyzed national and international guidelines. Forty-six relevant articles, reports and guidelines were identified and synthesized. Key considerations for COVID-19 mass vaccination clinics include establishing a leadership structure and key roles, identifying optional locations, clinic layout and workflow, day-to-day operations including infection prevention and control, and communication strategies. Ongoing data collection is required to evaluate and continuously improve mass vaccination efforts. Primary care can play a key role in organizing clinics and ensuring populations who have been made vulnerable by social and economic policies are being reached. Planning and implementing a successful COVID-19 mass vaccination campaign requires a number of key steps and considerations. As the COVID-19 vaccine rollout occurs in various countries, research will be required to identify key factors for success in different healthcare systems to inform future pandemic responses. 20 May, 2021. Under review, online-collection only. Permanent URL: http://hdl.handle.net/2027.42/167674
Essay: Everyone Can Use Ramps, So Don't Forget These "Steps": Disability Accessibility at COVID-19 Vaccination Sites
Michael McKee, Oluwaferanmi Okanlami, Philip Zazove
The COVID-19 pandemic affected everyone around the globe, but for some the impact was drastic and even more life-threatening. People with disabilities historically struggle with health inequities and inaccessible health care, but many of these disparities are now magnified due to the pandemic. Most of the safeguards put in place by health care systems to manage the pandemic were implemented without any input or consideration from individuals with disabilities. With the arrival of COVID vaccines, health care systems and vaccine administrators have the opportunity to ensure a more inclusive and accessible vaccine rollout plan to prevent further marginalization of our largest minority group. We present our story and list simple steps to ensure that the "shots in arms" get into everyone, not just the most "able bodied." 20 April, 2021. Non-refereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/167171
Original Research: Trust in Healthcare and Trust in Science Predict Readiness to Receive the COVID-19 Vaccine in Appalachia
Michelle Rockwell, Jeffrey Stein, Julie Gerdes, Jeremiah Brown, Adrienne Holz Ivory, John Epling
Virginia Tech Carilion School of Medicine
The Appalachian Region faces multiple barriers to widespread COVID-19 vaccination. The purpose of this research study was to explore the role of trust in healthcare and science on Appalachian residents' readiness to receive the COVID-19 vaccine and to describe trusted health influencers and information sources. A cross sectional survey study of Appalachia residents (n=1048) was completed between February 25 and March 6, 2021. Findings suggest that trust in healthcare and science are prospective foci for improving vaccine acceptance in Appalachia. As highly trusted influencers, primary care providers should be leveraged and supported in COVID-19 vaccine education and distribution. 6 April, 2021. 6 April, 2021. Non-refereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/167136
Special Report: The Impact of Race and History on COVID Vaccination Acceptance
Amanda Olagunju
Langley Air Force Base Hospital
This article delves into cultural and historical factors that negatively impact minority patient coronavirus vaccination acceptance. It provides a basic review of past transgressions committed against minority communities by American medical and scientific research fields. This article then discusses how medical providers can potentially address or mitigate minority patient fears about vaccination. 5 April, 2021. Non-refereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/167014
Innovation: Community Collaboration to Implement a Vaccination Clinic in Rural Areas
Roger Garvin, Ryan Norton, Joe Skariah, Sonja Likumahuwa-Ackman, Jennifer DeVoe, Stein Berger, Megan McGhean, Suzanne Sullivan, Deborah Cohen, Brian Garvey
Oregon Health & Science University
Primary care has delivered more vaccinations to people in the US than any other healthcare organization or entity. Patients seek vaccine advice from their primary care clinician, and this is no different for the COVID-19 vaccine. While mass COVID-19 vaccination sites are a critical piece of the greater public health strategy to immunize our communities, reaching older, underserved, and vaccine adverse communities will require engaging primary care and leveraging the trusting relationships practices establish with communities. Oregon Health & Science University Family Medicine Health Center, Scappoose, OR, collaborated with our rural county health department to establish a mass vaccination site at our clinic building. Based on our experience, we also developed a toolkit for decision-makers and implementers of vaccine clinics, designed to be a “vaccination clinic in a box,” that could be replicated in, and tailored to, many types of settings. 31 March, 2021. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/167008
Innovation: A Reflection on our Drive Through Flu Vaccine Clinic "Vires Rebus Adversis"
Tadhg Crowley
Facing great demand for the flu vaccine toward the end of 2020, and wanting to keep both patients and staff safe, the authors set about organizing Ireland's first drive-through flu vaccine clinic. During a ten-week period, (September 29th to December 5th, 2020) 1754 adult patients and 908 pediatric patients were vaccinated in their cars. On evaluation of this clinical innovation, which suggested high levels of satisfaction amongst staff and patients, we intend to replicate this approach for delivery of the Covid vaccine. 22 March, 2021. Non-refereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/166586
Guidelines for Accessible COVID-19 Testing & Vaccination Sites
Michael McKee, Oluwaferanmi Okanlami, Philip Zazove
Over 20% of individuals report a disability. These people often struggle with health inequities and poor health care access. Many of these barriers are addressable through simple steps. Providing an avenue for patients to communicate accessibility challenges and request accommodations prior to their appointment will help these individuals obtain their COVID-19 tests and vaccines equitably upon arrival. 17 February, 2021. Under review, online collection only. Permanent URL: http://hdl.handle.net/2027.42/166308
Original Research: Primary Care's Historic Role in Vaccination and Potential Role in COVID-19 Immunization Programs
John Westfall, Elizabeth Wilkinson, Anuradha Jetty, Stephen Petterson, Yalda Jabbarpour,
Robert Graham Center for Policy Studies in Family Medicine and Primary Care
COVID-19 pandemic recovery will require a broad and coordinated effort for infection testing, immunity determination, and vaccination. With the advent of several COVID-19 vaccines, the dissemination and delivery of COVID-19 immunization across the nation is of concern. A study of the delivery of vaccinations, using 2017 Medicare Part B Fee-For-Service data and the 2013-2017 Medical Expenditure Panel Survey at the service, physician, and visit level show that Primary Care Physicians have played a crucial role in delivery of vaccinations to the U.S. population, including the elderly, between 2012-2017. These findings indicate primary care practices may be a crucial element of vaccine counseling and delivery in the upcoming COVID-19 recovery and immunization efforts in the United States. 29 January, 2021. Accepted 1/28/2021, published 7/12/2021. URL: https://www.annfammed.org/content/19/4/351