COVID-19 vaccinations and counselling: a mixed-methods survey of Australian general practice in July 2021
Kathleen O’Brien
A * , Katelyn Barnes B , Sally Hall Dykgraaf C and Kirsty A. Douglas B
A Academic Unit of General Practice, Australian National University, Garran, ACT 2605, Australia.
B Academic Unit of General Practice, ACT Health/Australian National University, Garran, ACT 2605, Australia.
C Rural Clinical School, Australian National University, Canberra, ACT 2601, Australia.
Australian Journal of Primary Health 28(5) 399-407 https://doi.org/10.1071/PY21301
Submitted: 22 December 2021 Accepted: 6 April 2022 Published: 17 June 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY)
Abstract
Background: GPs are integral to the COVID-19 vaccination rollout, providing education and administering vaccines. We sought to describe how counselling relating to COVID-19 vaccination was impacting Australian general practice consultations.
Methods: We conducted an online, mixed-methods, cross-sectional survey of Australian community-based primary care from 7 to 15 July 2021. This survey, number 15 in a series of recurrent cross-sectional surveys conducted over a 14-month period, explored how counselling relating to COVID-19 vaccination was impacting general practice consultations, through multiple selection and open text responses; it also included questions on respondent and practice characteristics, and pandemic-related stress and strain. We calculated descriptive statistics for quantitative variables, and analysed free-text responses using an inductive content analysis approach.
Results: We received 73 responses (72 GPs) across all states/territories. Discussions with patients about COVID-19 vaccines and vaccination were common, increasing the duration of routine consultations by 6 min on average (s.d. 2.9). Respondents described the impact of the resulting time pressures, and the stress and challenges of participating in COVID-19 vaccine communication and administration. Although our results are illuminating, they are limited by the small sample, with some different characteristics from national estimates, an uncertain response rate and the inability to pilot the survey prior to distribution.
Conclusions: The significant impact on general practice consultation from COVID-19 vaccine counselling is on a background of ongoing pandemic-related stress and strain. With a strong track record of population vaccination, GPs are well-placed to deliver COVID-19 immunisations to the Australian population. However, they must be represented in planning and coordination, to reduce the overall burden on primary care.
Keywords: COVID-19, delivery of health care, general practice, immunisation programmes, pandemic, primary health care, vaccinations, vaccine counselling.
References
Annals of Family Medicine COVID-19 Collection (2021a) COVID-19 collection: global primary care during COVID-19. Available at https://www.annfammed.org/content/covid-19-collection-global-primary-care-during-covid-19. [Verified 24 November 2021]Annals of Family Medicine COVID-19 Collection (2021b) COVID-19 collection: primary care Covid-19 survey: Larry Green Center and Primary Care Collaborative. Available at https://www.annfammed.org/content/covid-19-collection-primary-care-covid-19-survey-larry-green-center-and-primary-care. [Verified 24 November 2021]
Australian Government Department of Health (2021a) COVID-19 vaccination – Australia’s COVID-19 vaccine national roll-out strategy. Available at: https://www.health.gov.au/resources/publications/covid-19-vaccination-australias-covid-19-vaccine-national-roll-out-strategy. [Verified 22 March 2022]
Australian Government Department of Health (2021b) COVID-19 vaccination – Community pharmacy COVID-19 vaccine rollout from Phase 2A. Available at: https://www.health.gov.au/resources/publications/covid-19-vaccination-community-pharmacy-covid-19-vaccine-rollout-from-phase-2a. [Verified 22 March 2022]
Australian Government Department of Health (2021c) First COVID-19 vaccinations in Australia. Available at: https://www.health.gov.au/news/first-covid-19-vaccinations-in-australia. [Verified 29 October 2021]
Australian Government Department of Health (2021d) Coronavirus (COVID-19) at a glance – 15 July 2021. Available at https://www.health.gov.au/resources/publications/coronavirus-covid-19-at-a-glance-15-july-2021. [Verified 16 November 2021]
Australian Government Department of Health (2021e) COVID-19 vaccines available soon for 16 to 39-year-olds. Available at https://www.health.gov.au/news/covid-19-vaccines-available-soon-for-16-to-39-year-olds. [Verified 29 October 2021]
Australian Government Department of Health (2022) General Practice Workforce providing Primary Care services in Australia. Available at https://hwd.health.gov.au/resources/data/gp-primarycare.html. [Verified 22 February 2022]
Australian Technical Advisory Group on Immunisation (ATAGI) (2021a) ATAGI statement on COVID-19 vaccination and a reported case of thrombosis. Available at https://www.health.gov.au/news/atagi-statement-covid-19-vaccination-reported-case-of-thrombosis. [Verified 12 October 2021]
Australian Technical Advisory Group on Immunisation (ATAGI) (2021b) ATAGI statement on revised recommendations on the use of COVID-19 Vaccine AstraZeneca, 17 June 2021. Available at https://www.health.gov.au/news/atagi-statement-on-revised-recommendations-on-the-use-of-covid-19-vaccine-astrazeneca-17-june-2021. [Verified 12 October 2021]
Breckenridge LA, Burns D, Nye C (2021) The use of motivational interviewing to overcome COVID-19 vaccine hesitancy in primary care settings. Public Health Nursing 1–6.
| The use of motivational interviewing to overcome COVID-19 vaccine hesitancy in primary care settings.Crossref | GoogleScholarGoogle Scholar |
Copp T, Isautier JMJ, Nickel B, et al. (2021) COVID-19 challenges faced by general practitioners in Australia: a survey study conducted in March 2021. Australian Journal of Primary Health 27, 357–363.
| COVID-19 challenges faced by general practitioners in Australia: a survey study conducted in March 2021.Crossref | GoogleScholarGoogle Scholar | 34586061PubMed |
Crimmins F (2021) Vax subsidies needed for counselling the hesitant, Medical Republic. Available at https://medicalrepublic.com.au/vax-subsidies-needed-for-counselling-the-hesitant/47448. [Verified 14 September 2021]
Danchin M, Biezen R, Manski-Nankervis J-A, et al. (2020) Preparing the public for COVID-19 vaccines: how can general practitioners build vaccine confidence and optimise uptake for themselves and their patients? Australian Journal of General Practice 49, 626–629.
| Preparing the public for COVID-19 vaccines: how can general practitioners build vaccine confidence and optimise uptake for themselves and their patients?Crossref | GoogleScholarGoogle Scholar |
Government of South Australia Department of Human Services (2021) COVID-19 update 321. Available at https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/covid-19/about+covid-19/latest+updates/covid-19+round+up+reports/covid-19+update+321. [Verified 08 April 2022]
Hanly M, Churches T, Fitzgerald O, MacIntyre CR, Jorm L (2021) Vaccinating Australia: how long will it take? Vaccine 40, 2491–2497.
| Vaccinating Australia: how long will it take?Crossref | GoogleScholarGoogle Scholar | 34284875PubMed |
Hanrahan C, Hayman R (2021) NSW COVID-19 vaccination rates rise 20 per cent as state battles Delta outbreak. ABC News. Available at https://www.abc.net.au/news/2021-08-13/nsw-vaccination-rates-rise-as-delta-rages/100370982. [Verified 29 October 2021]
Kidd M, de Toca L (2021) The contribution of Australia’s general practitioners to the COVID-19 vaccine rollout. Australian Journal of General Practice 50, 871–872.
| The contribution of Australia’s general practitioners to the COVID-19 vaccine rollout.Crossref | GoogleScholarGoogle Scholar | 34845474PubMed |
Kippen R, O’Sullivan B, Hickson H, Leach M, Wallace G (2020) A national survey of COVID-19 challenges, responses and effects in Australian general practice. Australian Journal of General Practice 49, 745–751.
| A national survey of COVID-19 challenges, responses and effects in Australian general practice.Crossref | GoogleScholarGoogle Scholar | 33123716PubMed |
Kyngäs H (2019) Inductive content analysis. Available at https://link.springer.com/chapter/10.1007/978-3-030-30199-6_2. [Verified 8 December 2021]
Lim G, Nguyen V (2021) Taking the pulse of the nation: wave 34 (31 May – 5 June 2021). Available at https://melbourneinstitute.unimelb.edu.au/publications/research-insights/ttpn/wave-34. [Verified 14 September 2021]
Medical Board (2021) Statistics. Available at https://www.medicalboard.gov.au/news/statistics.aspx. [Verified 17 September 2021]
Melbourne Institute (2021) Vaccine hesitancy tracker. Available at https://melbourneinstitute.unimelb.edu.au/publications/research-insights/ttpn/vaccination-report. [Verified 29 October 2021]
NSW Government Health (2021) More than 500K Pfizer doses for those aged 16-39 in LGAs of concern. Available at https://www.health.nsw.gov.au/news/Pages/20210818_00.aspx. [Verified 29 October 2021]
Premier of Victoria (2021) Vaccine eligibility expanding for anyone 16 and over. Available at https://www.premier.vic.gov.au/vaccine-eligibility-expanding-anyone-16-and-over. [Verified 29 October 2021]
Prime Minister of Australia (2021) Press conference – Canberra, ACT. Available at https://pmtranscripts.pmc.gov.au/release/transcript-43534. [Verified 8 June 2022]
Royal Australian College of General Practitioners (RACGP) (2015) ‘Smoking, nutrition, alcohol, physical activity (SNAP): a population health guide to behavioural risk factors in general practice.’ 2nd edn. (RACGP: Melbourne)
Royal Australian College of General Practitioners (RACGP) (2021a) General Practice Health of the Nation 2021. (RACGP: Melbourne, Victoria). Available at https://www.racgp.org.au/health-of-the-nation/health-of-the-nation. [Verified 22 October 2021]
Royal Australian College of General Practitioners (RACGP) (2021b) MBS COVID-19 vaccine suitability assessment service. Available at https://www.racgp.org.au/running-a-practice/practice-resources/medicare/medicare-benefits-schedule/covid-19-vaccine-suitability-assessment-service. [Verified 22 February 2022]
Sakkal P, Fowler M (2021) Rush to cancel AstraZeneca bookings as Pfizer access widened. The Age. Available at https://www.theage.com.au/national/victoria/rush-to-cancel-astrazeneca-bookings-as-pfizer-access-widened-20210824-p58lkb.html. [Verified 29 October 2021]
Scott A, Yang O (2021) Australians more likely to get vaccinated after Victoria’s COVID-19 outbreak. Pursuit. Available at https://pursuit.unimelb.edu.au/articles/australians-more-likely-to-get-vaccinated-after-victoria-s-covid-19-outbreak. [Verified 29 October 2021]
The Larry A Green Center (2021) Quick COVID-19 primary care survey. Series 29 fielded July 9-13, 2021. Available at https://www.green-center.org/s/C19_Series_29_National_Executive_Summary.pdf. [Verified 8 March 2022]
Tsirtsakis A (2021a) Growing number of Australians reject COVID vaccination. newsGP. Available at https://www1.racgp.org.au/newsgp/clinical/growing-number-of-australians-say-they-will-never. [Verified 14 September 2021]
Tsirtsakis A (2021b) From 40 calls to 261 in one morning: rollout issues continue. newsGP. Available at https://www1.racgp.org.au/newsgp/professional/from-40-calls-to-261-in-one-morning-rollout-issues. [Verified 29 October 2021]
Woodley M (2021) DoH responds to RACGP call for vaccine counselling flexibility. newsGP. Available at https://www1.racgp.org.au/newsgp/professional/doh-responds-to-racgp-call-for-vaccine-counselling. [Verified 14 September 2021]
Wright M, Versteeg R, Hall J (2020) General practice’s early response to the COVID-19 pandemic. Australian Health Review 44, 733–736.
| General practice’s early response to the COVID-19 pandemic.Crossref | GoogleScholarGoogle Scholar | 32878685PubMed |
