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Poor Interoperability Limited Primary Care COVID-19 Vaccination Efforts

Poor immunization interoperability prevented many primary care practices from identifying their unvaccinated patients during the COVID-19 pandemic.

According to a study published in Health Affairs, poor immunization data interoperability hampered primary care providers’ COVID-19 vaccination efforts.

Researchers analyzed data from the Centers for Disease Control and Prevention (CDC) and the PRIME Registry, a qualified clinical data registry with more than 2,000 primary care clinicians.

Primary care clinics received less than 5 percent of COVID-19 vaccines distributed by April 2021, likely contributing to population vaccination disparities. A national study revealed that individuals were more influenced by their PCPs to receive a COVID-19 vaccine than by recommendations from politicians, athletes, public figures, and scientists.

By the time vaccinations began in December 2020, primary care visits were approaching pre-pandemic levels, making it possible for primary care clinicians to vaccinate patients or capture vaccination information.

However, just before the COVID-19 pandemic began, the CDC reported that many practices could not access patient vaccination data reliably and easily, despite two decades of policy efforts to improve immunization reporting.

Immunization registries only capture about 60 percent of adults, and less than half of immunization data systems allow bidirectional immunization data sharing.

The study’s objective was to test the hypothesis that a lack of PCP inclusion in the national vaccination strategy and a lack of vaccine data interoperability meant that the setting where most people have a healthcare relationship was unable to vaccinate them or retrieve their COVID-19 vaccination status.

Nearly half (43.1 percent) of PRIME registry practices have no record of patients’ COVID-19 vaccinations, despite 11.2 percent of their 3.9 million patients having records of COVID-19 vaccination. Moreover, almost all the primary care clinics in the registry (93.4 percent) had provided or recorded other routine vaccinations during the same period.

“Unlike in other countries, primary care was not a prominent part of the US vaccination strategy, and the CDC’s report that less than 5 percent of primary care practices had vaccines by April 2021 fits our study pattern,” the authors wrote.

“The lack of a primary care vaccination strategy combined with poor data exchange from immunization information systems may explain our findings,” the researchers noted. “As the COVID-19 pandemic unfolded, these problems left primary care practices unable to identify their unvaccinated patients and leverage trusted relationships to improve vaccination rates.”

The authors suggested that further engagement with PCPs by public health epidemic response agencies and strategies that improve practices’ receipt of vaccines and vaccination data would aid in reducing vaccination uptake disparities.

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