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. 2024 Sep 4;24(1):1022.
doi: 10.1186/s12913-024-11422-0.

Exploring the feasibility and acceptability of community paramedicine programs in achieving vaccination equity: a qualitative study

Monica L Kasting  1   2 , Alfu Laily  3 , Sidney J Smith  3 , Sathveka Sembian  4 , Katharine J Head  5 , Bukola Usidame  3 , Gregory D Zimet  6 , Laura M Schwab-Reese  3
Affiliations

Exploring the feasibility and acceptability of community paramedicine programs in achieving vaccination equity: a qualitative study

Monica L Kasting et al. BMC Health Serv Res. .

Abstract

Background: Mobile Integrated Health-Community Paramedicine (MIH-CP) is a novel approach that may reduce the rural-urban disparity in vaccination uptake in the United States. MIH-CP providers, as physician extenders, offer clinical follow-up and wrap-around services in homes and communities, uniquely positioning them as trusted messengers and vaccine providers. This study explores stakeholder perspectives on feasibility and acceptability of community paramedicine vaccination programs.

Methods: We conducted semi-structured qualitative interviews with leaders of paramedicine agencies with MIH-CP, without MIH-CP, and state/regional leaders in Indiana. Interviews were audio recorded, transcribed verbatim, and analyzed using content analysis.

Results: We interviewed 24 individuals who represented EMS organizations with MIH-CP programs (MIH-CP; n = 10), EMS organizations without MIH-CP programs (non-MIH-CP; n = 9), and state/regional administrators (SRA; n = 5). Overall, the sample included professionals with an average of 19.6 years in the field (range: 1-42 years). Approximately 75% (n = 14) were male, and all identified as non-Hispanic white. MIH-CPs reported they initiated a vaccine program to reach underserved areas, operating as a health department extension. Some MIH-CPs integrated existing services, such as food banks, with vaccine clinics, while other MIH-CPs focused on providing vaccinations as standalone initiatives. Key barriers to vaccination program initiation included funding and vaccinations being a low priority for MIH-CP programs. However, participants reported support for vaccine programs, particularly as they provided an opportunity to alleviate health disparities and improve community health. MIH-CPs reported low vaccine hesitancy in the community when community paramedics administered vaccines. Non-CP agencies expressed interest in launching vaccine programs if there is clear guidance, sustainable funding, and adequate personnel.

Conclusions: Our study provides important context on the feasibility and acceptability of implementing an MIH-CP program. Findings offer valuable insights into reducing health disparities seen in vaccine uptake through community paramedics, a novel and innovative approach to reduce health disparities in rural communities.

Keywords: Community Paramedicine; Health inequities; Paramedicine; Rural Population; Vaccination Coverage.

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Conflict of interest statement

GDZ has served as an external advisory board member for Pfizer and Moderna, and as a consultant to Merck. MLK has served as a consultant to Merck. GDZ, KJH, LMSR, and MLK have received investigator-initiated research funding from Merck administered through Indiana University and Purdue University, respectively. The other co-authors have no relevant financial or non-financial interests to disclose.

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