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Most unvaccinated individuals said their ideal choice for getting a COVID-19 vaccine would be from their personal doctors, while most primary care physicians (PCP) reported that they are eager to give it.

In a recent survey, 53% of unvaccinated Americans said they , reported Dora Hughes, MD, MPH, associate research professor at the Milken Institute School of Public Health at George Washington University in Washington, at an Wednesday hosted by the Alliance for Health Policy.

Hughes cited polling data from the Commonwealth Fund and the African American Research Collaborative that looked at 3,541 unvaccinated respondents surveyed in June. Another 17% said they would prefer to go to a retail pharmacy or drugstore for their shot, while 13% said they would opt for a local clinic and 10% said they would choose a mass vaccination site in their community.

The survey found that the preference for getting vaccinated in a PCP's office was particularly strong among self-identified Republicans and rural Americans. Also, 39% of the unvaccinated said they didn't know how to get vaccinated, Hughes reported, with a majority of younger adults (51% of those ages 18-29 years) stating that they weren't sure how to get their shot.

Rebecca Weintraub, MD, assistant professor of global health and social medicine at Harvard Medical School in Boston, displayed a map of Alabama. She highlighted a number of , defined as places that would require a 15-minute drive or 30-minute walk to access a shot. But dotted along these deserts were primary care facilities that could fill the need.

"So there's an opportunity to mitigate the vaccine desert, if these sites are offered vaccine," she said.

Ready, Willing, and Able PCPs

In a separate by the Larry A. Green Center and the Primary Care Collaborative (PCC), about 74% of the 765 PCPs who responded stated that they were willing to vaccinate their patients against SARS-CoV-2. Also, 54% reported that their local health departments had not actively engaged PCP offices to help with vaccine distribution. Only 9% said they had a "reliable vaccine vendor," and know when doses would arrive.

President Biden on Tuesday laid out a five-point plan to get more shots into arms, including renewed efforts to bring vaccines into PCP and pediatricians' offices, although the plan was short on details.

Ann Greiner, MCP, PCC president and CEO, noted that there is an overall disconnect between public health and primary care. She stressed that state health departments need stronger information exchange between their offices and PCP offices.

She said that primary care wants to do more to help reach vaccine goals, "but frankly are ... challenged in many states to even know who in their patient population is vaccinated."

However, Greiner said there was hope, most notably with the American Rescue Plan, which includes billions in funding for public health with a "one-time opportunity" to rebuild the sector, which has seen declines in investment for some time, she added.

Greiner hopes a key focus area will be modernizing state health departments to support "bidirectional communication" and data exchange between public health and primary care.

'Family Event'

Weintraub urged pediatricians to think of vaccination as a "family event." If COVID-19 vaccines become available to those ages 5 to 11 years in the fall, then pediatricians must be prepared to offer the shot to any unvaccinated parents, grandparents, or other guardians who accompany the patient, she said.

Weintraub recommended starting the conversation with a discussion on the impact of the pandemic on patients' lives -- economic distress, lifestyle disruptions, the challenges of remote learning, for example. "The vaccine is a secondary conversation," and it's "one element of re-engaging with your preventative care." However, she stressed that physicians need to be reimbursed for this time and effort.

And any conversation is a challenge when there are language barriers. Michelle Morse, MD, MPH, chief medical officer and deputy commissioner of the Center for Health Equity and Community Wellness for the New York City Department of Health and Mental Hygiene, explained that in her city there are hundreds of indigenous communities -- mostly immigrants from Central America. Finding an interpreter who can help conduct important conversations with these patients in their indigenous languages can be a "profound challenge," she said.

Still, Federally Qualified Health Centers "have been one of the in our vaccination campaign, and have overcome many of those barriers," she stated.

Finally, Morse noted that there are (clinics, hospitals, pharmacies) in neighborhoods where there are people of color, "so if we don't find a race-explicit way to invest in to ensure access, we're going to be at the same place when the next pandemic happens."

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