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. 2023 Apr 19;13(4):e065306.
doi: 10.1136/bmjopen-2022-065306.

What is the role of primary care in the COVID-19 vaccine roll-out and the barriers and facilitators to an equitable vaccine roll-out? A rapid scoping review of nine jurisdictions

Monica Aggarwal  1 , Kristina Marie Kokorelias  2   3 , Richard H Glazier  4   5   6   7 , Alan Katz  8 , Jessica E Shiers-Hanley  9 , Ross E G Upshur  4   7
Affiliations

What is the role of primary care in the COVID-19 vaccine roll-out and the barriers and facilitators to an equitable vaccine roll-out? A rapid scoping review of nine jurisdictions

Monica Aggarwal et al. BMJ Open. .

Abstract

Objectives: This study aimed to: (1) examine the experience of nine global jurisdictions that engaged primary care providers (PCPs) to administer COVID-19 vaccines during the pandemic; (2) describe how vaccine hesitancy and principles of equity were incorporated in the COVID-19 vaccine roll-out strategies and (3) identify the barriers and facilitators to the vaccine roll-out.

Design: Rapid scoping review.

Data sources: Searches took place in MEDLINE, CINAHL, Embase, the Cochrane Library, SCOPUS and PsycINFO, Google, and the websites of national health departments. Searches and analyses took place from May 2021 to July 2021.

Results: Sixty-two documents met the inclusion criteria (35=grey literature; 56% and 27=peer reviewed; 44%). This review found that the vaccine distribution approach started at hospitals in almost all jurisdictions. In some jurisdictions, PCPs were engaged at the beginning, and the majority included PCPs over time. In many jurisdictions, equity was considered in the prioritisation policies for various marginalised communities. However, vaccine hesitancy was not explicitly considered in the design of vaccine distribution approaches. The barriers to the roll-out of vaccines included personal, organisational and contextual factors. The vaccine roll-out strategy was facilitated by establishing policies and processes for pandemic preparedness, well-established and coordinated information systems, primary care interventions, adequate supply of providers, education and training of providers, and effective communications strategy.

Conclusions: Empirical evidence is lacking on the impact of a primary care-led vaccine distribution approach on vaccine hesitancy, adoption and equity. Future vaccine distribution approaches need to be informed by further research evaluating vaccine distribution approaches and their impact on patient and population outcomes.

Keywords: COVID-19; GENERAL MEDICINE (see Internal Medicine); Health policy; PUBLIC HEALTH.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
PRISMA-DIAGRAM. Adapted from: Page et al. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
See this image and copyright information in PMC

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References

    1. Ramasamy MN, Minassian AM, Ewer KJ, et al. . Safety and immunogenicity of chadox1 ncov-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): a single-blind, randomised, controlled, phase 2/3 trial. Lancet 2021;396:1979–93. 10.1016/S0140-6736(20)32466-1 - DOI - PMC - PubMed
    1. Mills MC, Salisbury D. The challenges of distributing COVID-19 vaccinations. EClinicalMedicine 2021;31:100674. 10.1016/j.eclinm.2020.100674 - DOI - PMC - PubMed
    1. Ratzan S, Schneider EC, Hatch H, et al. . Missing the point-how primary care can overcome covid-19 vaccine “ hesitancy. ” N Engl J Med 2021;384:e100. 10.1056/NEJMp2106137 - DOI - PubMed
    1. Lazarus JV, Ratzan SC, Palayew A, et al. . A global survey of potential acceptance of a COVID-19 vaccine. Nat Med 2021;27:225–8. 10.1038/s41591-020-1124-9 - DOI - PMC - PubMed
    1. SAGE Working Group on Vaccine Hesitancy . Vaccine hesitancy: definition, scope and determinants. Vaccine 2015;33:4161–4. 10.1016/j.vaccine.2015.04.036 - DOI - PubMed

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