Counteracting vaccine fatigue
One of the silver linings I found during the past 3 years of the COVID-19 pandemic has been the breaking down of some of the silos that we work in and the increased collaboration throughout different components of the primary health care system. In providing an example of this I’d like to share information about an innovative and successful program, enabling team care, which has helped improve health outcomes in my community.
I recently participated in South West Sydney Primary Health Network’s (SWSPHN) COVID-19 Small Grants Program. The initiative sought to improve COVID-19 vaccination rates in vulnerable communities in South Western Sydney. This region with its significant diversity and low underlying socio-economic determinants of health outcomes suffered quite significantly during the pandemic with high infection rates and hospitalisations and the social challenges of living under strict curfews.
I was certainly keen to participate in the program supporting Bankstown, Camden, Campbelltown, Fairfield, Liverpool, Wollondilly and Wingecarribee local government areas.
The program aimed to support general practices and pharmacies to ensure continuity of COVID-19 vaccinations for vulnerable groups and to increase health literacy among vaccine hesitant patients. Participating practices and pharmacies received grants of $10,000 for a two-month period. What was particularly relevant to our multidisciplinary health team practice was funding was directed for the health care team and not specifically for face to face GP time allowing other members of our team to spend time discussing COVID-19 vaccines with patients in an attempt to increase uptake of COVID-19 vaccinations.
Participating practices and pharmacies in the local region carried out conversations with patients identified as vaccine hesitant about the benefits of vaccination and where possible offered them assistance to access the vaccine. We were also supported to spend time identifying vulnerable population groups using clinical software and to recall those that were under vaccinated and discuss vaccination and to connect vulnerable populations to COVID-19 vaccine providers.
Ninety practices participated across the 7 Local Government Areas and the split was fairly even across general practice and pharmacies with 42 general practices and 48 pharmacies participating.
During the first month of the program 3722 conversations were undertaken by the participating practices leading to 1739 extra vaccination doses. In the second month of the program a further 3494 conversations with vulnerable patients took place and this culminated in an additional 1304 vulnerable and high-risk patients being vaccinated against COVID-19.
The program produced many good news stories about improving patients’ literacy on COVID-19 vaccination, informing and assisting vulnerable patients, and enhancing vaccination take-up.
The findings of the program evaluation, the good news stories mentioned and practice reports indicate that this program had many benefits for both the participating practices and patients.
The key strengths noted were:
- Significant increase in vaccination uptake in vulnerable populations.
- Further development of SWSPHN relationships with previously engaged practices and pharmacies.
- Ease and timeliness of implementation.
Limitations of the program were noted as:
- Limited engagement from GP Practices in languages other than English.
- Confusion from practices around invoicing and reporting.
- Not all approved practices participated and were lost to follow up.
Whilst the program had its limitations, overall it was certainly successful in achieving the stated objectives in increasing vaccination rates and health literacy in vulnerable members of South West Sydney’s Community. The feedback from general practitioners and the pharmacists involved as well as the number of COVID-19 vaccinations administered indicated that the program had been an effective way to support GP’s and practices during the COVID-19 response.
Moving forward any limitations to the program could be addressed with solutions such as:
- directed outreach to Aboriginal Torres Strait Islander and culturally and linguistically diverse services;
- invoice templates; and
- more structured interaction with participating practices to attract engagement and give support where needed.
Overall, an extra 3043 residents of South West Sydney who were unvaccinated or under vaccinated benefited from this program by obtaining relevant immunisation.
I certainly found the assistance from the Primary Health Network a beneficial and innovative way to use the most cost effective and efficient component of our health system that is primary care to deal with overcoming some of the issues relating to pandemic vaccination fatigue.
Certainly, it’s highlighted the health benefits that can be achieved when adequate GP funding is available, particularly for the most vulnerable members of our community.
Dr Ken McCroary, NSW Representative to AMA Council of General Practice
