However, sending Covid vaccines to doctor’s offices, which usually do a large part of routine adult vaccinations, is not as easy as it sounds. Five months after the Covid-19 vaccinations began, many states are still going through doctors to address their concerns about the requirements for handling the shots. The situation underscores the difficulty facing the Biden administration in the next segment of the largest and most complex vaccination campaign in US history.
A particular challenge for many doctors: the vaccines are sent in large quantities. Two of the approved shots – those from Pfizer and Moderna – have cold storage requirements that can be difficult for some medical practices, especially in rural areas where vaccine hesitation tends to be higher. And depending on the shot, vials can contain anywhere from 5 to 15 doses to be used the same day after opening, increasing the likelihood of doses being wasted in small settings like doctor’s offices.
White House officials said they are working to resolve these issues and vowed that doctors will play an important role in President Joe Biden’s new push to vaccinate at least 70 percent of adults by July 4th. Biden said last week that pediatricians will be the key to vaccinating children as millions of younger teenagers are expected to soon be eligible for the shot by Pfizer and its German partner BioNTech.
Surveys have often shown that doctors are viewed as trustworthy vaccine messengers, and their relationship with patients could be critical in overcoming hesitation or skepticism.
“As we move into the next phase of our vaccination programs, it is clear that first responder involvement will be a critical part of that effort,” said a senior administrator.
While the federal government has shipped tens of millions of doses directly to community health centers and drugstore retail stores, the official does not plan any similar efforts for doctor’s offices.
Instead, the government has worked with states that control the distribution for about half of the Covid shots produced to prioritize doses for primary care in areas included in the Centers for Disease Control and Prevention’s Index of Social Vulnerability communities most in need rank support based on factors such as transport access, housing conditions and poverty levels.
White House officials, who telephoned governors privately on Tuesday, urged them to get more vaccines for pediatricians and general practitioners, according to two sources. The White House has also considered encouraging emergency medical services to give the vaccine when a patient is discharged. This emerges from three sources that are aware of the conversations.
Several states have started shipping vaccines to doctors in the past few weeks and have established a wide network of willing vaccines. With one of the lowest vaccination rates in the country, Louisiana now allows any doctor, regardless of their specialty, to take Covid shots. New Mexico, which has spearheaded the nation’s fastest vaccine rollout for months, is now giving 11 percent of its doses to pediatricians and gynecologists in addition to primary care providers.
But elsewhere, state officials said they still face other challenges in recruiting doctors. One of these is simply understanding which primary care practices in their states want to administer shots – and how many.
“With states, they differ dramatically in their ability to connect with primary care practices,” said Ann Greiner, president and CEO of the nonprofit Primary Care Collaborative. “I know states that do not have the data on basic service practices in their state. Some have very close relationships.”
The inclusion of admissions with doctors is expected to help increase vaccination rates. However, that alone is not enough to reclaim a significant portion of the land that has not yet been vaccinated. To start with, an estimated quarter of Americans say they don’t have a basic provider.
About 57 percent received at least one dose, and a Kaiser Family Foundation survey As of Thursday, only 9 percent of unvaccinated adults were found to have been shot. About 20 percent of adults have consistently said they are strongly against the vaccine.
State officials who now have more vaccines than they can administer are eager to try new strategies. Until recently, Virginia had advised doctors to only order what they were sure they could distribute that week, which discouraged many doctors, especially smaller practices, from participating. Now that supply is so far ahead of demand, the state is working to attract more doctors.
“The most important thing is to have a vaccine on hand. When your patients walk in, you have the option to fire that shot right away,” said Danny Avula, the state vaccination coordinator.
However, some doctors have concerns about the potential for wasted doses in small settings where the number of people looking for vaccines could fluctuate unpredictably. While some people schedule a vaccination appointment in advance, health professionals expect doctors to be able to convince patients they see for other health concerns to get vaccinated locally.
Medical groups have urged administration to make vaccines available in single-dose vials to reduce waste. The government official at Biden said the government is looking into this, but the three Covid-19 vaccine companies used in the United States have not announced any plans to do so.
State officials are urging doctors not to worry about doses being wasted, a feeling that would have been unthinkable just a few months ago when vaccines were scarce.
“Given that supply has exceeded demand, we urge vendors to do their best … but don’t cause stress,” said Tracie Collins, New Mexico Minister of Health. “There is no way we want to waste vaccines, but we want to vaccinate as many people as possible.”
Medical trade groups are working with the Biden Administration to publicize that vaccines are increasingly available to doctors. Some doctors have felt discouraged about their ability to get vaccines, which is why they haven’t signed up to be given Covid shots, said Susan Bailey, president of the American Medical Association. She said some doctors in her Fort Worth, Texas ward signed up to receive doses back in December but haven’t received them yet.
Maryland has been running one of the largest tests in the country since mid-March to send Covid recordings to doctors. A pilot program distributed vaccines to 37 primary care practices serving primarily black and Hispanic communities. Data showed that black and Hispanic patients were vaccinated in the practices at higher rates than their state representative, according to Howard Haft, the state official who ran the program.
The program has now been expanded to almost 240 practices and is expected to expand to around 400 in the coming weeks. Participating doctors can review state health information exchanges to see if their patients have been vaccinated. You will be asked to contact those who have not yet received a shot.
“Patients prefer to get information from their trusted providers,” said Haft, “and when given the choice, they prefer to get the vaccinations in their offices.”