Recommending COVID-19 Vaccines to Patients: Practice and Concerns of Frontline Family Doctors

Abstract

Background: Recommendation from doctors is a well-recognized motivator toward vaccine uptake. Family doctors are in the prime position to advise the public on COVID-19 vaccination. We studied the practice and concerns of frontline family doctors concerning COVID-19 vaccination recommendations to patients. Methods: We conducted a cross-sectional online survey of all family doctors in the Hong Kong College of Family Physicians between June and July 2021. Their practice of making COVID-19 recommendation to patients was assessed. Based on the Health Belief Model, factors associated with doctors’ recommendation practices were explored and examined. Multivariate logistic regression models were used to investigate the factors, including COVID-19 vaccine attributes, associated with doctors’ practices in making recommendations. Their own vaccination status and psychological antecedents to vaccine hesitancy were measured. Results: A total of 312 family doctors responded (a 17.6% response rate). The proportion of doctors who had received COVID-19 vaccines was 90.1%. The proportion of doctors who would recommend all patients without contraindications for the vaccination was 64.4%. The proportion of doctors who would proactively discuss COVID-19 vaccines with patients was 52.9%. Multivariate logistic regression analysis showed that doctors’ own COVID-19 vaccination status was the strongest predictor of family doctors making a recommendation to patients (aOR 12.23 95% CI 3.45–43.33). Longer duration of practice, willingness to initiate the relevant discussion with patients and less worry about vaccine side effects on chronic illness patients were the other factors associated with making a COVID-19 vaccination recommendation. Conclusions: Family doctors should be encouraged to get vaccinated themselves and initiate discussions with patients about COVID-19 vaccines. Vaccine safety data on patients with chronic illness, training and guidelines for junior doctors may facilitate the COVID-19 vaccination recommendation practices of family doctors.

Vaccine Resistance and Hesitancy among Older Adults Who Live Alone or Only with an Older Partner in Community in the Early Stage of the Fifth Wave of COVID-19 in Hong Kong

“…In addition, doctors’ recommendation is one of the factors for older adults in vaccine decision making since they were unclear whether they were appropriate to take vaccines and would like to ask their doctors. Nevertheless, in our previous study, over 35% of frontline doctors would not recommend their patients without contraindications for the vaccination in practice [ 20 ], which could be due to the uncertainties on benefits and side effects when vaccines were first available. These might be the reasons why the non-vaccination rate was high among older adults.…”

“…The questionnaire was developed based on our previous studies involving older adults and vaccination status [ 19 , 20 ]. The survey included some non-standard questions, which were developed by a group of epidemiologists, doctors, nurses, and social workers.…”

Models of determinants of COVID-19 vaccine hesitancy in non-pregnant and pregnant population: Review of current literature”

“…In a study evaluating physician attitudes, HBM was used to evaluate physician likelihood of recommending vaccinations. 21 It has also been used to assess pharmacists’ and other health-care workers’ vaccine acceptance and hesitancy. 22–26 Studies have used the HBM to assess parent attitudes toward childhood vaccinations.…”

“… 22–26 Studies have used the HBM to assess parent attitudes toward childhood vaccinations. 27–32 Globally, the HBM has been used to assess general vaccine hesitancy in Nigeria, 33 the United States, 29 and Korea; 30 measles and rubella vaccines in Romania and Japan; 27 , 34 shingles vaccines in the United Kingdom; 35 influenza vaccines in the United States, 36–39 Japan, 27 and Australia; 40 human papilloma virus vaccines in the United States; 28 , 31 , 41–48 and COVID-19 vaccines in the United States, 21 , 44–46 China, 47–53 Bangladesh, 54–56 Turkey, 22 Canada, 23 Vietnam, 57 France, 58 Saudi Arabia, 59 and Pakistan. 60 Several other studies applied HBM to create interventions to increase vaccine knowledge and uptake, 16 and to create new scales of vaccine attitudes and intentions to assess the effectiveness of health campaigns and advertising.…”

“… 60 Several other studies applied HBM to create interventions to increase vaccine knowledge and uptake, 16 and to create new scales of vaccine attitudes and intentions to assess the effectiveness of health campaigns and advertising. 21 , 30 , 31 …”