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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE (Open Access)

Vaccine provider views on the impact of COVID-19 on immunisation in general practice: a qualitative study

Tobias Morgan https://orcid.org/0000-0002-6904-1201 A * , Abela Mahimbo B , Mark Harris A and Anita Heywood A
+ Author Affiliations
- Author Affiliations

A University of New South Wales (UNSW), School of Population Health and Community Medicine, Sydney, NSW 2052, Australia.

B University of Technology Sydney (UTS), School of Public Health, Ultimo, NSW 2007, Australia.

* Correspondence to: t.morgan@student.unsw.edu.au

Australian Journal of Primary Health 28(6) 535-541 https://doi.org/10.1071/PY22003
Submitted: 5 January 2022  Accepted: 8 June 2022   Published: 8 August 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-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background: General practitioners and general practice nurses are the most trusted and experienced sources of vaccine information for Australians and are the principal providers of routine immunisation in New South Wales, Australia. This study explored perceived barriers and challenges to the rollout of the COVID-19 immunisation program and continued provision of routine immunisation through general practice.

Methods: Structured in-depth interviews were conducted between 29 April and 8 July 2021 with general practitionerss and general practice nurses working in accredited general practices in the Greater Sydney area. Interviews were transcribed verbatim and analysed thematically.

Results: Fifteen participants (12 general practitioners and three general practice nurses) were interviewed. Participants considered the COVID-19 vaccine rollout to significantly burden general practice at the cost of delivery of routine preventative care. Patient fear and anxiety and vaccine hesitancy were perceived as major challenges to the provision of all immunisations, exacerbated by media coverage of shifting recommendations related to COVID-19 vaccine adverse events. Inadequate communication from government bodies contributed to a perceived erosion of patient trust in general practice. Participants considered routine immunisation to be minimally disrupted owing to robust practice-based recall and reminder systems and legislated immunisation requirements for children.

Conclusion: The role of general practitioners and general practice nurses in the COVID-19 vaccine rollout was seen to be one of great burden and complexity. As the primary providers of immunisation in New South Wales, continued communication with and support for general practice, both financially and informationally, is pivotal to the sustained successful provision of routine and COVID-19 immunisation.

Keywords: Australia, COVID-19, COVID-19 vaccines, general practice, government, primary care, qualitative research, vaccination.


References

ATAGI (2020) Guiding principles for maintaining immunisation services during the COVID-19 pandemic. Available at https://www.health.gov.au/resources/publications/atagi-guiding-principles-for-maintaining-immunisation-services-during-covid-19-pandemic [Accessed 21 July 2021]

ATAGI (2021a) Joint statement from ATAGI and THANZ on Thrombosis with Thrombocytopenia Syndrome (TTS) and the use of COVID-19 Vaccine AstraZeneca. Available at https://www.health.gov.au/news/joint-statement-from-atagi-and-thanz-on-thrombosis-with-thrombocytopenia-syndrome-tts-and-the-use-of-covid-19-vaccine-astrazeneca [Accessed 5 July 2021]

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 [Accessed 5 July 2021]

Attwooll J (2021) Pressure on GPs as pharmacies drop out of COVID booster rollout. RACGP NewsGP. Available at https://www1.racgp.org.au/newsgp/professional/pressure-on-gps-as-pharmacies-drop-out-of-covid-bo [Accessed 23 November 2021]

Australian Bureau of Statistics (2021) Household impacts of COVID-19 survey. Available at https://www.abs.gov.au/statistics/people/people-and-communities/household-impacts-covid-19-survey [Accessed 13 November 2021]

Beard FH, Hendry AJ, Macartney K (2021) Influenza vaccination uptake in Australia in 2020: impact of the COVID-19 pandemic? Communicable Diseases Intelligence 45, 1–4.
Influenza vaccination uptake in Australia in 2020: impact of the COVID-19 pandemic?Crossref | GoogleScholarGoogle Scholar |

Berry NJ, Henry A, Danchin M, Trevena LJ, Willaby HW, Leask J (2017) When parents won’t vaccinate their children: a qualitative investigation of Australian primary care providers’ experiences. BMC Pediatrics 17, 19
When parents won’t vaccinate their children: a qualitative investigation of Australian primary care providers’ experiences.Crossref | GoogleScholarGoogle Scholar |

Brewer NT, Chapman GB, Rothman AJ, Leask J, Kempe A (2017) Increasing vaccination: putting psychological science into action. Psychological Science in the Public Interest 18, 149–207.
Increasing vaccination: putting psychological science into action.Crossref | GoogleScholarGoogle Scholar |

Chow M, Danchin M, Willaby H, Pemberton S, Leask J (2017) Parental attitudes, beliefs, behaviours and concerns towards childhood vaccinations in Australia: a national online survey. Australian Journal for General Practitioners 46, 145–151.

Clarke M, Thomas N, Giles L, Marshall H (2015) Community awareness and predictors of uptake of pertussis booster vaccine in South Australian adults. Vaccine 33, 7337–7343.
Community awareness and predictors of uptake of pertussis booster vaccine in South Australian adults.Crossref | GoogleScholarGoogle Scholar |

Copp T, Isautier JMJ, Nickel B, Pickles K, Tracy M, Doust J, 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 |

Department of Health (2017) Immunisation coverage annual report, 2014. Available at https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi4101j.htm [Accessed 11 August 2021]

Department of Health (2021a) Current coverage data tables for all children. Available at https://www.health.gov.au/health-topics/immunisation/childhood-immunisation-coverage/current-coverage-data-tables-for-all-children [Accessed 2 August 2021]

Department of Health (2021b) Immunisation coverage rates for all children. Available at https://www.health.gov.au/health-topics/immunisation/childhood-immunisation-coverage/immunisation-coverage-rates-for-all-children [Accessed 2 August 2021]

Department of Health (2021c) COVID-19 vaccine rollout update – 17 December 2021. Available at https://www.health.gov.au/sites/default/files/documents/2021/12/covid-19-vaccine-rollout-update-17-december-2021 [Accessed 13 March 2022]

Department of Health (2021d) Influenza (flu) immunisation data – 5 October 2021. Available at https://www.health.gov.au/sites/default/files/documents/2021/10/influenza-flu-immunisation-data-influenza-flu-immunisation-data-5-october-2021.pdf [Accessed 14 October 2021]

Desborough J, Hall Dykgraaf S, de Toca L, Davis S, Roberts L, Kelaher C, Kidd M (2020) Australia’s national COVID-19 primary care response. The Medical Journal of Australia 213, 104–106.e1.
Australia’s national COVID-19 primary care response.Crossref | GoogleScholarGoogle Scholar |

Frew PM, Lutz CS (2017) Interventions to increase pediatric vaccine uptake: an overview of recent findings. Human Vaccines & Immunotherapeutics 13, 2503–2511.
Interventions to increase pediatric vaccine uptake: an overview of recent findings.Crossref | GoogleScholarGoogle Scholar |

Harris RC, Chen Y, Côte P, Ardillon A, Nievera MC, Ong-Lim A, et al. (2021) Impact of COVID-19 on routine immunisation in South-East Asia and Western Pacific: disruptions and solutions. The Lancet Regional Health – Western Pacific 10, 100140
Impact of COVID-19 on routine immunisation in South-East Asia and Western Pacific: disruptions and solutions.Crossref | GoogleScholarGoogle Scholar |

Hull BP, Hendry AJ, Dey A, Bryant K, Radkowski C, Pellissier S, et al. (2021) The impact of the COVID-19 pandemic on routine vaccinations in Victoria. Medical Journal of Australia 215, 83–84.
The impact of the COVID-19 pandemic on routine vaccinations in Victoria.Crossref | GoogleScholarGoogle Scholar |

Jacobson Vann JC, Jacobson RM, Coyne-Beasley T, Asafu-Adjei JK, Szilagyi PG (2018) Patient reminder and recall interventions to improve immunization rates. Cochrane Database of Systematic Reviews CD003941
Patient reminder and recall interventions to improve immunization rates.Crossref | GoogleScholarGoogle Scholar |

Kaufman J, Attwell K (2021) Maintaining routine vaccination during the COVID-19 pandemic. Medical Journal of Australia 214, 93–93.e1.
Maintaining routine vaccination during the COVID-19 pandemic.Crossref | GoogleScholarGoogle Scholar |

Kippen R, O’Sullivan B, Hickson H, Leach M, Wallace G (2020) National survey of COVID 19 challenges. Australian Journal of General Practice 49, 745–751.
National survey of COVID 19 challenges.Crossref | GoogleScholarGoogle Scholar |

Leask J, Carlson S, Attwell K, Clark K, Kaufman J, Hughes C, et al. (2021) Communicating with patients and the public about COVID-19 vaccine safety: recommendations from the Collaboration on Social Science in Immunisation. The Medical Journal of Australia 215, 9–12.e1.
Communicating with patients and the public about COVID-19 vaccine safety: recommendations from the Collaboration on Social Science in Immunisation.Crossref | GoogleScholarGoogle Scholar |

Levesque J-F, Harris MF, Russell G (2013) Patient-centred access to health care: conceptualising access at the interface of health systems and populations. International Journal for Equity in Health 12, 18
Patient-centred access to health care: conceptualising access at the interface of health systems and populations.Crossref | GoogleScholarGoogle Scholar |

Melbourne Institute: Applied Economic & Social Research (2021) Vaccine Hesitancy Report Card. (Melbourne Institute: Applied Economic & Social Research: Melbourne, Vic., Australia) Available at https://melbourneinstitute.unimelb.edu.au/publications/research-insights/ttpn/vaccination-report [Accessed 3 November 2021]

Northwood K, Siskind D, Suetani S, McArdle PA (2021) An assessment of psychological distress and professional burnout in mental health professionals in Australia during the COVID-19 pandemic. Australasian Psychiatry 29, 628–634.
An assessment of psychological distress and professional burnout in mental health professionals in Australia during the COVID-19 pandemic.Crossref | GoogleScholarGoogle Scholar |

Pearce C, McLeod A, Gardner K, Supple J (2021) COVID-19 and Australian general practice: the impact of vaccination programs. (Outcome Health: Melbourne) Available at http://www.polargp.org.au/wp-content/uploads/2021/06/COVID19-Insights-Paper-8-Vaccination.pdf [Accessed 26 October 2021]

Pope C, Mays N (1995) Qualitative Research: Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. BMJ 311, 42–45.
Qualitative Research: Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research.Crossref | GoogleScholarGoogle Scholar |

Royal Australian College of General Practitioners (RACGP) (2020) RACGP survey reveals strong take up of telehealth but face to face consultations still available [media release]. Available at https://www.racgp.org.au/gp-news/media-releases/2020-media-releases/may-2020/racgp-survey-reveals-strong-take-up-of-telehealth [Accessed 23 September 2021]

Shields B (2020) Vaccine supply fight escalates as EU demands millions of doses from UK. (Sydney Morning Herald). Available at https://www.smh.com.au/world/europe/vaccine-supply-fight-escalates-as-eu-demands-millions-of-doses-from-uk-20210128-p56xcj.html [Accessed 12 September 2021]

Thorne S (2000) Data analysis in qualitative research. Evidence-Based Nursing 3, 68–70.
Data analysis in qualitative research.Crossref | GoogleScholarGoogle Scholar |

Trent MJ, Salmon DA, MacIntyre CR (2021a) Using the health belief model to identify barriers to seasonal influenza vaccination among Australian adults in 2019. Influenza and Other Respiratory Viruses 15, 678–687.
Using the health belief model to identify barriers to seasonal influenza vaccination among Australian adults in 2019.Crossref | GoogleScholarGoogle Scholar |

Trent MJ, Salmon DA, MacIntyre CR (2021b) Pharmacy, workplace or primary care? Where Australian adults get their influenza vaccines. Australian and New Zealand Journal of Public Health 45, 385–390.
Pharmacy, workplace or primary care? Where Australian adults get their influenza vaccines.Crossref | GoogleScholarGoogle Scholar |

WHO (2020) Pulse survey of continuity of essential health services during the COVID-19 pandemic: interim report, 27 August 2020. Available at https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2020.1 [Accessed 1 September 2021]

Woodley M (2021) Numbers confirm GPs are the ‘backbone’ of COVID vaccine rollout. RACGP NewsGP. Available at https://www1.racgp.org.au/newsgp/professional/numbers-confirm-gps-are-the-backbone-of-covid-vacc [Accessed 13 October 2021]