Perspectives of primary care physicians on acceptance and barriers to COVID-19 vaccination

ObjectivesThe purpose of this study was to examine the perspectives of primary care physicians in Texas around vaccine acceptance and potential patient barriers to vaccination. National surveys have shown fluctuating levels of acceptance for COVID-19 vaccination, and primary care physicians could play a crucial role in increasing vaccine uptake.DesignThis study employed a cross-sectional anonymous survey design to collect data using an online questionnaire. Participants were asked about vaccination practices and policies at their practice site, perceptions of patient and community acceptance and confidence in responding to patient vaccine concerns.SettingFrom November 2020 to January 2021, family medicine physicians and paediatricians completed an online questionnaire on COVID-19 vaccination that was distributed by professional associations.ParticipantsThe survey was completed by 573 practising physicians, the majority of whom identified as family medicine physicians (71.0%) or paediatricians (25.7%), who are currently active in professional associations in Texas.ResultsAbout three-fourths (74.0%) of participants reported that they would get the vaccine as soon as it became available. They estimated that slightly more than half (59.2%) of their patients would accept the vaccine, and 67.0% expected that the COVID-19 vaccine would be accepted in their local community. The majority of participants (87.8%) reported always, almost always or usually endorsing vaccines, including high levels of intention to recommend COVID-19 vaccination (81.5%). Participants felt most confident responding to patient concerns related to education about vaccine types, safety and necessity and reported least confidence in responding to personal or religious objections to COVID-19 vaccination.ConclusionsThe majority of the physicians surveyed stated that they would receive the COVID-19 vaccination when it was available to them and were confident in their ability to respond to patient concerns. With additional education, support and shifting COVID-19 vaccinations into primary care settings, primary care physicians can use the trust they have built with their patients to address vaccine hesitancy and potentially increase acceptance and uptake.

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Could this be measles?

Emergency Medicine Journal ◽

10.1136/emermed-2019-208490 ◽

2019 ◽

Vol 36 (5) ◽

pp. 310-314 ◽

Cited By ~ 4

Author(s):

Shaun O’Donnell ◽

Ffion Davies ◽

Madhur Vardhan ◽

Patrick Nee

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Measles Virus ◽

International Travel ◽

Childhood Illness ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Diagnostic Challenge ◽

International Programme ◽

The Usa

Infection with the measles virus causes an unpleasant disease with many potentially serious complications. It is predominantly a childhood illness but can affect any age. Measles is extraordinarily contagious, but immunisation with measles containing vaccine provides comprehensive protection. An international programme of universal immunisation from the mid-1980s has been very effective; measles was declared eliminated in the USA nearly two decades ago and became a rarity in other countries with high rates of vaccine uptake. Until recently, this was a forgotten disease in high-income countries, but paediatricians, emergency and primary care physicians worldwide are now encountering measles with increased frequency. Attributed to international travel and pockets of vaccine hesitancy locally, new outbreaks of measles have been recorded in many regions thought to have been free of the disease. Because it was previously so uncommon, measles presents a diagnostic challenge and an unrecognised case may cause infection to spread among communities. The present article presents a case of confirmed measles infection and discusses the epidemiology, clinical features, investigation, management and prevention of measles.

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Exercise Counseling by Primary Care Physicians in Jordan—A Preliminary Study

Journal of Primary Care & Community Health ◽

10.1177/2150132720946947 ◽

2020 ◽

Vol 11 ◽

pp. 215013272094694

Author(s):

Othman Beni Yonis ◽

Rami Saadeh ◽

Zaher Chamseddin ◽

Hussam Alananzeh

Keyword(s):

Primary Care ◽

Family Medicine ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Public And Private ◽

Logistic Regression Models ◽

Exercise Counseling ◽

Chi Square Test

Despite the value of physical activity and exercise to patients, little is known about the perception and practices of Jordanian primary care physicians (PCPs) regarding counseling patients about exercise. This study was aimed at assessing counseling about exercise by PCPs in Jordan. A cross-sectional study targeting a random sample of physicians from family medicine, internal medicine and general practice in academic, public, and private sectors. Chi-square test of independence was used to assess the association of perceptions and practices of physicians regarding exercise counseling with their specialty. Logistic regression models were used to examine the association of demographic information with selected items of perception and practice. A total of 218 physicians participated in the study. They were mainly males (67%), family medicine physicians (42.2%), and had a mean age of 33.7 (±9.87) years. Most physicians believed that less than half of patients will start exercising (91.3%) or will continue exercising if they were repeatedly counseled at follow-up visits (85.4%). Family medicine physicians counseled more patients, more frequently, and their desire to counsel more patients was significantly higher than other physicians ( P = .002). The Perceptions and practices of Jordanian PCPs toward exercise counseling for their patients were found positive; however the desire to counsel more patients was low. Lack of patients’ motivation to practice exercise, time constraint and limited resources were the most frequently reported barriers to counseling. Further investigation on how to overcome such barriers is recommended.

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What are the knowledge, attitudes and beliefs regarding concussion of primary care physicians and family resident physicians in rural communities?

Journal of Concussion ◽

10.1177/2059700220974548 ◽

2020 ◽

Vol 4 ◽

pp. 205970022097454

Author(s):

Heather Galbraith ◽

Jairus Quesnele ◽

Shannon Kenrick-Rochon ◽

Sylvain Grenier ◽

Tara Baldisera

Keyword(s):

Primary Care ◽

Family Medicine ◽

Primary Care Physicians ◽

Assessment Tool ◽

Local Health ◽

Cross Sectional ◽

Support Tool ◽

Family Medicine Resident ◽

Medicine Resident ◽

Resident Physicians

Background Primary care physicians and family medicine resident physicians report continued gaps in knowledge when diagnosing and managing pediatric patients with concussion. Methods A cross-sectional electronic survey of 130 primary care physicians and family medicine resident physicians in the Northeastern Ontario Local Health Integration Network (LHIN). Descriptive statistics, chi-squared Fisher exact tests, were used to compare physicians versus resident physicians with two-tailed p < 0.05 (with 95% confidence intervals). Results With a 48% response rate, when treating concussions 44% of providers either did not use any specific clinical practice guideline, standardized assessment tool, could not recall the source of a specific tool/guideline or omitted answering the question. However, 61% of all respondents would refer some or all concussion patients to a specialist for treatment. At least 41% of providers indicated they lacked access to a ‘Provider Decision Support Tool’ specific to concussion, and 88% of the 25 providers were without access to discharge instructions. Conclusion Similar to other jurisdictions, Northeastern Ontario primary care physicians and family medicine resident physicians report gaps in knowledge for both diagnosis and management of pediatric concussion. Consequently, they did not use current guidelines or best practices to guide management.

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Factors associated with the intention of Syrian adult population to accept COVID19 vaccination: a cross-sectional study

BMC Public Health ◽

10.1186/s12889-021-11361-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Okbah Mohamad ◽

Ali Zamlout ◽

Naseem AlKhoury ◽

Abd Aljawad Mazloum ◽

Marah Alsalkini ◽

...

Keyword(s):

Adult Population ◽

Developed Countries ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Online Questionnaire ◽

Cross Sectional ◽

Factors Associated ◽

Attitudinal Factors ◽

Population Demographic

Abstract Background and objectives With global efforts to develop and deliver a COVID-19 vaccine rapidly, vaccine hesitancy stands as a barrier to these efforts. We aimed to estimate the proportion of Syrian adult population intending to be vaccinated against COVID-19 and, principally, to assess the demographic and attitudinal factors associated with it in order to approach suitable solutions. Methods An anonymous online questionnaire was conducted between 23rd December 2020 and 5th January 2021 in various provinces in Syria. A total of 3402 adults were sampled to reflect the population demographic factors. Attitudinal factors included Covid-19 fears, risks, and beliefs on the origin. Vaccination hesitancy and knowledge were also measured. The intention to get vaccinated against COVID-19 was the primary endpoint. Results According to their statements, 1222 participants (35.92%) will consent to get vaccinated against COVID-19. Our findings indicate that male gender, younger age, rural residence, not having children, smoking, fear about COVID-19, individual perceived severity, believing in the natural origin of the coronavirus, and high vaccination knowledge were positive predictors of embracing COVID-19 vaccine when it is available. Conclusion COVID-19 vaccine acceptance rate is considerably poor across Syrian population compared to populations in developed countries. Vaccine hesitancy is closely bound to the fear of side effects and doubts about vaccine efficacy. Factors such as conspiracy beliefs and myths about the vaccine lower vaccine uptake. Thus, interventional educational campaigns are increasingly required to overcome misinformation and avert low vaccination acceptance rates.

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Physician Burnout in Primary Care during the COVID-19 Pandemic: A Cross-Sectional Study in Portugal

Journal of Primary Care & Community Health ◽

10.1177/21501327211008437 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110084

Author(s):

Sofia Baptista ◽

Andreia Teixeira ◽

Luísa Castro ◽

Maria Cunha ◽

Carla Serrão ◽

...

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Strong Association ◽

Cross Sectional Study ◽

Depression And Anxiety ◽

Sectional Study ◽

Physician Burnout ◽

Contributing Factors ◽

Online Questionnaire ◽

Cross Sectional

Background Primary care physicians have been present on the frontline during the ongoing pandemic, adding new tasks to already high workloads. Our aim was to evaluate burnout in primary care physicians during the COVID-19 pandemic, as well as associated contributing factors. Methods Cross-sectional study with an online questionnaire disseminated through social media, applying the snowball technique. The target population was primary care physicians working in Portugal during the first outbreak of the COVID-19 pandemic. In addition to sociodemographic data, the questionnaire collected responses to the Copenhagen Burnout Inventory (CBI), the Resilience Scale and the Depression, Anxiety, and Stress Scales (DASS-21). Data were collected from May 9 to June 8, 2020, a period comprising the declaration of a national calamity and then state of emergency, and the subsequent ease of lockdown measures. Levels of burnout in 3 different dimensions (personal, work, and patient-related), resilience, stress, depression, and anxiety were assessed. Logistic regression analyses were conducted to identify factors associated with burnout levels. Results Among the 214 physician respondents, burnout levels were high in the 3 dimensions. A strong association was found between gender, years of professional experience, depression and anxiety, and burnout levels. Conclusions Physician burnout in primary care is high and has increased during the pandemic. More studies are needed in the long term to provide a comprehensive assessment of COVID-19’simpact on burnout levels and how to best approach and mitigate it during such unprecedented times.

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SARS-CoV-2: Vaccine Hesitancy among Underrepresented Racial and Ethnic Groups with HIV in Miami, Florida

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab154 ◽

2021 ◽

Author(s):

Deborah L Jones ◽

Ana S Salazar ◽

Violeta J Rodriguez ◽

Raymond R Balise ◽

Claudia Uribe Starita ◽

...

Keyword(s):

Race And Ethnicity ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Baseline Survey ◽

Advisory Group ◽

Medical Mistrust ◽

Cross Sectional ◽

Exact Test ◽

Novel Coronavirus

Abstract Background SARS-CoV-2 and HIV disproportionally affect underrepresented ethnoracial groups in the US. Medical mistrust and vaccine hesitancy will likely impact acceptability of SARS-CoV-2 vaccines. This study examined SARS-CoV-2 vaccine hesitancy among underrepresented ethnoracial groups with HIV and identified factors that may reduce vaccine uptake. Methods We conducted a cross-sectional study of adults ≥18 years with HIV residing in Miami, FL. Participants were invited to participate in the ACTION (A Comprehensive Translational Initiative on Novel Coronavirus) cohort study. A baseline survey was administered from April-August 2020 and followed by a COVID-19 vaccine hesitancy survey from August-November 2020. The COVID-19 vaccine hesitancy survey was adapted from the Strategic Advisory Group Experts survey. Comparisons by race and ethnicity were performed using the Freedman-Haltmann extension of Fisher’s exact test Results A total of 94 participants were enrolled, mean age 54.4 years, 52% female, 60% Black non-Latinx, and 40% non-Black Latinx. Black non-Latinx participants were less likely to agree that vaccinations are important for health when compared to non-Black Latinx (67.8% vs 92.1%, p=0.009), less likely to agree that vaccines are effective in preventing disease (67.8% vs 84.2%, p=0.029), less likely to believe that vaccine information is reliable and trustworthy (35.7% vs 71.1%, p=0.002), and less likely to believe vaccines were unnecessary because COVID-19 would disappear soon (11% vs 21%, p=0.049). Conclusion Medical mistrust, vaccine hesitancy and negative sentiments about SARS-CoV-2 vaccines are prevalent among underrepresented ethnoracial groups with HIV, particularly Black non-Latinx. Targeted strategies to increase vaccine uptake in this population are warranted.

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Willingness to Receive the COVID-19 and Seasonal Influenza Vaccines among the Saudi Population and Vaccine Uptake During the Initial Stage of the National Vaccination Campaign: A Cross-Sectional Survey

Vaccines ◽

10.3390/vaccines9070765 ◽

2021 ◽

Vol 9 (7) ◽

pp. 765

Author(s):

Amel Ahmed Fayed ◽

Abeer Salem Al Shahrani ◽

Leenah Tawfiq Almanea ◽

Nardeen Ibrahim Alsweed ◽

Layla Mohammed Almarzoug ◽

...

Keyword(s):

Saudi Arabia ◽

Perceived Risk ◽

Online Survey ◽

Seasonal Influenza ◽

Vaccination Campaign ◽

Vaccine Uptake ◽

Influenza Vaccines ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

To Receive

This study aimed to assess the willingness to receive the coronavirus disease 2019 (COVID-19) and seasonal influenza vaccines and vaccine uptake during the early stage of the national vaccination campaign in Saudi Arabia. A cross-sectional online survey was conducted among adult Saudis between 20 January and 20 March 2021. The questionnaire addressed vaccine hesitancy, perceived risk, willingness, and vaccine uptake. Approximately 39% of the participants expressed vaccine hesitancy, and 29.8% and 24% felt highly vulnerable to contracting COVID-19 and seasonal influenza, respectively. The majority (59.5%) were willing to receive the COVID-19 vaccine, although only 31.7% were willing to receive the flu vaccine. Adjusted analysis showed that vaccine hesitancy (OR 0.34, 95% CI 0.27–0.43) and the perception of being at high risk (OR 2.78, 95% CI 1.68–4.60) independently affected the intention to be vaccinated. Vaccine hesitancy was similar among those who were willing to be vaccinated (29.8%) and those who had already been vaccinated (33.1%). The perceived risk was significantly higher among those who had been vaccinated (48.1%) than among those who were willing to be vaccinated but had not yet been vaccinated (29.1%). In conclusion, the acceptance of the COVID-19 vaccine in Saudi Arabia is high. Saudis who received the vaccine had a similar level of vaccine hesitancy and a higher level of perceived risk.

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Knowledge, attitude and practice of evidence-based medicine among primary care practitioners in Malaysia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-044372 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044372

Author(s):

Mat Nawi Zanaridah ◽

Mohd Noor Norhayati ◽

Zakaria Rosnani

Keyword(s):

Primary Care ◽

Evidence Based Medicine ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Evidence Based ◽

Sectional Study ◽

Primary Care Practitioner ◽

Cross Sectional ◽

Primary Care Practitioners ◽

Based Medicine

ObjectivesTo determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia.SettingThis cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM.ParticipantsThe study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice.ResultsA total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones.ConclusionsAlthough many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.

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Prepared and highly committed despite the risk of COVID-19 infection: a cross-sectional survey of primary care physicians’ concerns and coping strategies in Singapore

BMC Family Practice ◽

10.1186/s12875-021-01370-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jerrald Lau ◽

David Hsien-Yung Tan ◽

Gretel Jianlin Wong ◽

Yii-Jen Lew ◽

Ying-Xian Chua ◽

...

Keyword(s):

Primary Care ◽

Coping Strategies ◽

Stress Management ◽

Primary Care Physicians ◽

Well Being ◽

Pandemic Preparedness ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Accessible Information ◽

And Coping

Abstract Background Primary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic. This study examines PCPs’ concerns, impact on personal lives and work, and level of pandemic preparedness in the context of COVID-19 in Singapore. We also examine factors and coping strategies that PCPs have used to manage stress during the outbreak. Methods Two hundred and sixteen PCPs actively practicing in either a public or private clinic were cluster sampled via email invitation from three primary care organizations in Singapore from 6th to 29th March 2020. Participants completed a cross-sectional online questionnaire consisting of items on work- and non-work-related concerns, impact on personal and work life, perceived pandemic preparedness, stress-reduction factors, and personal coping strategies related to COVID-19. Results A total of 158 questionnaires were usable for analyses. PCPs perceived themselves to be at high risk of COVID-19 infection (89.9%), and a source of risk (74.7%) and concern (71.5%) to loved ones. PCPs reported acceptance of these risks (91.1%) and the need to care for COVID-19 patients (85.4%). Overall perceived pandemic preparedness was extremely high (75.9 to 89.9%). PCPs prioritized availability of personal protective equipment, strict infection prevention guidelines, accessible information about COVID-19, and well-being of their colleagues and family as the most effective stress management factors. Conclusions PCPs continue to serve willingly on the frontlines of this pandemic despite the high perception of risk to themselves and loved ones. Healthcare organizations should continue to support PCPs by managing both their psychosocial (e.g. stress management) and professional (e.g. pandemic preparedness) needs.

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Global Prevalence and Drivers of Dental Students’ COVID-19 Vaccine Hesitancy

Vaccines ◽

10.3390/vaccines9060566 ◽

2021 ◽

Vol 9 (6) ◽

pp. 566

Author(s):

Abanoub Riad ◽

Huthaifa Abdulqader ◽

Mariana Morgado ◽

Silvi Domnori ◽

Michal Koščík ◽

...

Keyword(s):

International Association ◽

Cross Sectional Study ◽

Dental Students ◽

Vaccine Hesitancy ◽

Online Questionnaire ◽

Cross Sectional ◽

Middle Income ◽

Related Attitude ◽

The Media ◽

Acceptance Levels

Background: Acceleration of mass vaccination strategies is the only pathway to overcome the COVID-19 pandemic. Healthcare professionals and students have a key role in shaping public opinion about vaccines. This study aimed to evaluate the attitudes of dental students globally towards COVID-19 vaccines and explore the potential drivers for students’ acceptance levels. Methods: A global cross-sectional study was carried out in February 2021 using an online questionnaire. The study was liaised by the scientific committee of the International Association of Dental Students (IADS), and data were collected through the national and local coordinators of IADS member organizations. The dependent variable was the willingness to take the COVID-19 vaccine, and the independent variables included demographic characteristics, COVID-19-related experience, and the drivers of COVID-19 vaccine-related attitude suggested by the WHO SAGE. Results: A total of 6639 students from 22 countries, representing all world regions, responded to the questionnaire properly. Their mean age was 22.1 ± 2.8 (17–40) years, and the majority were females (70.5%), in clinical years (66.8%), and from upper-middle-income economies (45.7%). In general, 22.5% of dental students worldwide were hesitant, and 13.9% rejected COVID-19 vaccines. The students in low- and lower-middle-income (LLMI) economies had significantly higher levels of vaccine hesitancy compared to their peers in upper-middle- and high-income (UMHI) economies (30.4% vs. 19.8%; p < 0.01). Conclusions: The global acceptance level of dental students for COVID-19 vaccines was suboptimal, and their worrisome level of vaccine hesitancy was influenced by the socioeconomic context where the dental students live and study. The media and social media, public figures, insufficient knowledge about vaccines, and mistrust of governments and the pharmaceutical industry were barriers to vaccination. The findings of this study call for further implementation of epidemiology (infectious diseases) education within undergraduate dental curricula.

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