Recommending COVID-19 Vaccines to Patients: Practice and Concerns of Frontline Family Doctors
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. Data Collection
2.2.1. Primary Outcome
2.2.2. Considerations and Practice on Making COVID-19 Vaccination Recommendation
2.2.3. General Vaccine Acceptance
2.2.4. Own COVID-19 Vaccination Status
2.2.5. Demographic and Practice-Related Variables
2.3. Statistical Analysis
3. Results
4. Discussion
4.1. Summary
4.2. Strengths and Limitations
4.3. Comparing with Existing Literature
4.4. Implications for Research and Practice
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
VOC | Variants of Concern |
HK | Hong Kong |
HKCFP | Hong Kong College of Family Physicians |
FRACGP | Fellowship of Royal Australian College of General Practitioners |
ORs | odds ratios |
CIs | confidence intervals |
References
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All Respondents | Recommend Vaccination to All Patients without Contraindications | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
No * | Yes | |||||||||
Variable | n = 312 (%) | n = 111 (%) | n = 201 (%) | p ~ | Crude OR | 95% CI | ||||
Gender | ||||||||||
Male | 160 | 51.3 | 50 | 45.0 | 110 | 54.7 | 0.101 | Ref | ||
Female | 152 | 48.7 | 61 | 55.0 | 91 | 45.3 | 0.68 | 0.43 | 1.08 | |
Postgraduate qualification (any) | ||||||||||
No | 56 | 17.9 | 28 | 25.2 | 28 | 13.9 | 0.013 | Ref | ||
Yes | 256 | 82.1 | 83 | 74.8 | 173 | 86.1 | 2.08# | 1.16 | 3.74 | |
Specialty | ||||||||||
Family medicine specialist @ | ||||||||||
No | 178 | 57.1 | 69 | 62.2 | 109 | 54.2 | 0.175 | Ref | ||
Yes | 134 | 42.9 | 42 | 37.8 | 92 | 45.8 | 1.39 | 0.86 | 2.23 | |
General practitioner (i.e., a non-specialist) with a postgraduate qualification in family medicine (e.g., diploma) | ||||||||||
No | 187 | 59.9 | 64 | 57.7 | 123 | 61.2 | 0.542 | Ref | ||
Yes | 125 | 40.1 | 47 | 42.3 | 78 | 38.8 | 0.86 | 0.54 | 1.38 | |
Type of practice | ||||||||||
Public | 164 | 52.6 | 67 | 60.4 | 97 | 48.3 | 0.033 | Ref | ||
Private | 147 | 47.1 | 43 | 38.7 | 104 | 51.7 | 1.67# | 1.04 | 2.68 | |
Others | 1 | 0.3 | 1 | 0.9 | 0 | 0.0 | - | - | - | |
Year of practice | ||||||||||
<10 years | 57 | 18.3 | 38 | 34.2 | 19 | 9.5 | <0.001 | Ref | ||
11–20 years | 107 | 34.3 | 46 | 41.4 | 61 | 30.3 | 2.65^ | 1.36 | 5.19 | |
>20 years | 148 | 47.4 | 27 | 24.3 | 121 | 60.2 | 8.96& | 4.49 | 17.89 | |
Offered a COVID-19 vaccination service in their clinic | ||||||||||
No | 117 | 37.5 | 56 | 50.5 | 61 | 30.3 | <0.001 | Ref | ||
Yes | 195 | 62.5 | 55 | 49.5 | 140 | 69.7 | 2.34^ | 1.45 | 3.77 |
All Participants | Have Vaccinated | Will Vaccinate in Next 12 Months | Not Vaccinate | |||||
---|---|---|---|---|---|---|---|---|
Variable | n = 312 (%) | n = 281 (%) | n = 28 (%) | n = 3 (%) | ||||
Recommend all patients withoutcontraindications for vaccination | ||||||||
Yes | 201 | 64.4 | 197 | 70.1 | 4 | 14.3 | 0 | 0.0 |
No | 111 | 35.6 | 84 | 29.9 | 24 | 85.7 | 3 | 100.0 |
Proactively discuss vaccination with patients | ||||||||
Yes | 165 | 52.9 | 156 | 55.5 | 9 | 32.1 | 0 | 0.0 |
No | 147 | 47.1 | 125 | 44.5 | 19 | 67.9 | 3 | 100.0 |
All Respondents | Recommend Vaccinations to All Patients without Contraindications | ||||||||
---|---|---|---|---|---|---|---|---|---|
No * | Yes | ||||||||
Variable | n = 312 (%) | n = 111 (%) | n = 201 (%) | Crude OR | 95% CI | ||||
Have received COVID-19 vaccine | |||||||||
No | 31 | 9.9 | 27 | 24.3 | 4 | 2.0 | Ref | ||
Yes | 281 | 90.1 | 84 | 75.7 | 197 | 98.0 | 15.83& | 5.37 | 46.65 |
Proactively discuss with patients | |||||||||
No | 147 | 47.1 | 80 | 72.1 | 67 | 33.3 | Ref | ||
Yes | 165 | 52.9 | 31 | 27.9 | 134 | 66.7 | 5.16& | 3.11 | 8.58 |
Attributes of vaccine to consider when making recommend | |||||||||
Availability of Phase III clinical trials data | |||||||||
No | 77 | 24.7 | 14 | 12.6 | 63 | 31.3 | Ref | ||
Yes | 235 | 75.3 | 97 | 87.4 | 138 | 68.7 | 0.32& | 0.17 | 0.60 |
Vaccine efficacy | |||||||||
No | 30 | 9.6 | 7 | 6.3 | 23 | 11.4 | Ref | ||
Yes | 282 | 90.4 | 104 | 93.7 | 178 | 88.6 | 0.52 | 0.22 | 1.26 |
Side effects | |||||||||
No | 25 | 8.0 | 5 | 4.5 | 20 | 10.0 | Ref | ||
Yes | 287 | 92.0 | 106 | 95.5 | 181 | 90.0 | 0.43 | 0.16 | 1.17 |
Approved by local government | |||||||||
No | 141 | 45.2 | 66 | 59.5 | 75 | 37.3 | Ref | ||
Yes | 171 | 54.8 | 45 | 40.5 | 126 | 62.7 | 2.46 & | 1.53 | 3.96 |
Listed by WHO for emergency use | |||||||||
No | 163 | 52.2 | 62 | 55.9 | 101 | 50.2 | Ref | ||
Yes | 149 | 47.8 | 49 | 44.1 | 100 | 49.8 | 1.25 | 0.79 | 2.00 |
Vaccine type (e.g., inactivated vaccine, mRNA) | |||||||||
No | 151 | 48.4 | 54 | 48.6 | 97 | 48.3 | Ref | ||
Yes | 161 | 51.6 | 57 | 51.4 | 104 | 51.7 | 1.02 | 0.64 | 1.62 |
Manufacturer | |||||||||
No | 202 | 64.7 | 68 | 61.3 | 134 | 66.7 | Ref | ||
Yes | 110 | 35.3 | 43 | 38.7 | 67 | 33.3 | 0.79 | 0.49 | 1.28 |
Consider susceptibility of individual patient when making recommendation | |||||||||
Agree | 192 | 61.5 | 75 | 67.6 | 117 | 58.2 | Ref | ||
Neutral | 63 | 20.2 | 27 | 24.3 | 36 | 17.9 | 0.86 | 0.48 | 1.52 |
Disagree | 57 | 18.3 | 9 | 8.1 | 48 | 23.9 | 3.42^ | 1.59 | 7.37 |
Consider severity of COVID in individual patient when making recommendation | |||||||||
Agree | 64 | 20.5 | 31 | 27.9 | 33 | 16.4 | Ref | ||
Neutral | 42 | 13.5 | 26 | 23.4 | 16 | 8.0 | 0.58 | 0.26 | 1.28 |
Disagree | 206 | 66.0 | 54 | 48.6 | 152 | 75.6 | 2.64^ | 1.48 | 4.72 |
There are insufficient data to support recommendation | |||||||||
Agree | 97 | 31.1 | 46 | 41.4 | 51 | 25.4 | Ref | ||
Neutral | 93 | 29.8 | 40 | 36.0 | 53 | 26.4 | 1.20 | 0.67 | 2.12 |
Disagree | 122 | 39.1 | 25 | 22.5 | 97 | 48.3 | 3.50& | 1.93 | 6.34 |
Worried of serious side effects in patients with chronic illness | |||||||||
Agree | 113 | 36.2 | 65 | 58.6 | 48 | 23.9 | Ref | ||
Neutral | 67 | 21.5 | 25 | 22.5 | 42 | 20.9 | 2.28^ | 1.22 | 4.23 |
Disagree | 132 | 42.3 | 21 | 18.9 | 111 | 55.2 | 7.16 & | 3.94 | 13.01 |
Need additional laboratory test for making recommendation | |||||||||
Agree | 149 | 47.8 | 64 | 57.7 | 85 | 42.3 | Ref | ||
Neutral | 79 | 25.3 | 30 | 27.0 | 49 | 24.4 | 1.23 | 0.70 | 2.15 |
Disagree | 84 | 26.9 | 17 | 15.3 | 67 | 33.3 | 2.97^ | 1.59 | 5.54 |
Need clearer guidelines for making recommendation | |||||||||
Agree | 128 | 41.0 | 66 | 59.5 | 62 | 30.8 | Ref | ||
Neutral | 78 | 25.0 | 23 | 20.7 | 55 | 27.4 | 2.55 ^ | 1.40 | 4.63 |
Disagree | 106 | 34.0 | 22 | 19.8 | 84 | 41.8 | 4.07& | 2.27 | 7.29 |
5C model | |||||||||
Confidence | 5.58 | 1.17 | 5.13 | 1.13 | 5.82 | 1.11 | 1.69& | 1.37 | 2.08 |
Complacency | 1.97 | 0.93 | 2.26 | 1.00 | 1.82 | 0.85 | 0.60& | 0.46 | 0.77 |
Constraints | 2.11 | 1.27 | 2.50 | 1.34 | 1.90 | 1.19 | 0.69& | 0.57 | 0.83 |
Calculation | 6.37 | 0.82 | 6.40 | 0.63 | 6.35 | 0.91 | 0.93 | 0.69 | 1.24 |
Collective responsibility | 4.87 | 0.77 | 4.89 | 0.80 | 4.86 | 0.75 | 0.96 | 0.70 | 1.30 |
Variable | aOR # | 95% CI | p | |
---|---|---|---|---|
Years of practice | ||||
<10 years | Ref | |||
11–20 years | 1.20 | 0.53 | 2.71 | 0.663 |
>20 years | 3.55 | 1.49 | 8.44 | 0.004 |
Have received vaccine | ||||
No | Ref | |||
Yes | 12.23 | 3.45 | 43.33 | <0.001 |
Proactively discuss with patients | ||||
No | Ref | |||
Yes | 3.62 | 1.84 | 7.14 | <0.001 |
Attributes of COVID-19 vaccine to consider when making recommendation | ||||
Availability of Phase III clinical trial data | 0.38 | 0.16 | 0.88 | 0.024 |
Vaccine type (e.g., inactivated vaccine, mRNA) | 0.44 | 0.22 | 0.85 | 0.015 |
Worry about the side effects on patients who have chronic illnesses | ||||
Agree | Ref | |||
Neutral | 2.49 | 1.14 | 5.45 | 0.023 |
Disagree | 3.59 | 1.72 | 7.47 | 0.001 |
5C model | ||||
Confidence | 1.37 | 1.03 | 1.83 | 0.031 |
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Poon, P.K.M.; Zhou, W.; Chan, D.C.C.; Kwok, K.O.; Wong, S.Y.S. Recommending COVID-19 Vaccines to Patients: Practice and Concerns of Frontline Family Doctors. Vaccines 2021, 9, 1319. https://doi.org/10.3390/vaccines9111319
Poon PKM, Zhou W, Chan DCC, Kwok KO, Wong SYS. Recommending COVID-19 Vaccines to Patients: Practice and Concerns of Frontline Family Doctors. Vaccines. 2021; 9(11):1319. https://doi.org/10.3390/vaccines9111319
Chicago/Turabian StylePoon, Paul Kwok Ming, Weiju Zhou, Dicken Cheong Chun Chan, Kin On Kwok, and Samuel Yeung Shan Wong. 2021. "Recommending COVID-19 Vaccines to Patients: Practice and Concerns of Frontline Family Doctors" Vaccines 9, no. 11: 1319. https://doi.org/10.3390/vaccines9111319
APA StylePoon, P. K. M., Zhou, W., Chan, D. C. C., Kwok, K. O., & Wong, S. Y. S. (2021). Recommending COVID-19 Vaccines to Patients: Practice and Concerns of Frontline Family Doctors. Vaccines, 9(11), 1319. https://doi.org/10.3390/vaccines9111319