Reducing COVID-19 Vaccine Hesitancy by Implementing Organizational Intervention in a Primary Care Setting in Bahrain

Abstract

Background: Refusal to receive the COVID-19 vaccine or hesitancy is a global threat. Hence, reducing vaccine hesitancy is the next challenge for policymakers and the healthcare system. However, people trust healthcare professionals more than any other source of information. Accordingly, planning for an effective process and competent healthcare professional to elicit and address the patient's concerns is an imperative measure. This quality improvement project aimed to improve physicians' COVID-19 vaccine advice to reduce vaccine hesitancy.

Methods: The study used judgmental sampling and involved 665 hesitant patients over 19 weeks. The team utilized the Plan-Do-Study-Act method to implement COVID-19 vaccine physicians' reminders and upgrades physicians' communication skills to conduct an effective tailored communication that addresses the patient's concerns toward COVID-19 vaccines. The team used pre-post design to evaluate the impact of counseling on the hesitancy rate of patients before and after the intervention over time. The main outcomes were the percentage of physicians' COVID-19 vaccine advice for patients and the percentage of hesitancy rate before and after implementation.

Results: There were 665 hesitant patients before intervention. However, after the intervention, the number decreased to 193 patients, and the control chart revealed a reliable process. The percentage of recommendations by physicians has increased from 1% to 51% after 19 weeks of implementation and with a controlled process.

Conclusion: The study has found that rectifying process barriers and upgrading physicians' skills would improve the COVID-19 vaccine counseling rate and introducing tailored communication would reduce the hesitancy rate. Nevertheless, the study was constrained by a lack of information on the impact of social media and national measures on patients' decisions. Additional studies with more emphasis on other patients' behavior determinants are necessary.

Keywords: covid-19 vaccine; herd immunity; patient counseling; patient education; vaccine hesitancy.

Figure 1. Control chart COVID-19 vaccine counseling rate pre- and post-intervention

Figure 2. Control chart COVID-19 vaccine hesitancy rate pre- and post-intervention