Hospitalist perspectives on barriers to recommend and potential benefit of the COVID-19 vaccine

Hosp Pract (1995). 2021 Apr 7. doi: 10.1080/21548331.2021.1914465. Online ahead of print.

Abstract

Background: Hospitalists, comprised of nurse practitioners and physician assistants (collectively, advanced practice providers [APPs]) and physicians, have opportunities to counsel patients and reduce SARS-CoV-2 related coronavirus disease 2019 (COVID-19) vaccine hesitancy. However, hospitalist perspectives on the COVID-19 vaccine and potential differences between APPs and physicians are unknown. Understanding hospitalist perspectives could help to address vaccine hesitancy among patients.

Methods: We conducted an online survey of hospitalists at Mayo Clinic sites in Arizona, Florida, Minnesota, and Wisconsin from December 14, 2020, through January 4, 2021. We collected demographic information and assessed perspectives on the COVID-19 vaccine and, for comparison, on the influenza vaccine. Descriptive statistics were used to compare responses between APPs and physicians.

Results: The overall response rate was 42.7% (n=128/300) and comprised of 53.9% women (n=69/128) and 41.4% APPs (n=53/128). Most hospitalists reported receiving or planning to receive vaccination against COVID-19 (93.7%; n=119/128) and influenza (97.7%; n=125/128). Most hospitalists reported they would advise 100% of patients to receive the COVID-19 vaccine (66% for APPs; 74.7% for physicians) and influenza vaccine (83% for APPs; 80% for physicians). Barriers to recommending the COVID-19 vaccine included patient health status and vaccine safety profile. Hospitalists reported that patients and co-workers receiving the COVID-19 vaccine would reduce their anxiety (~80% of hospitalists), social isolation (~64% of hospitalists), and improve their emotional support (~40% of hospitalists). APP and physician responses were similar. The possible reduction in social isolation was associated with higher odds of hospitalists advising all patients to receive the COVID-19 vaccine (adjusted odds ratio 2.95 [95% confidence interval, 1.32-6.59]; P<.008), whereas hospitalist age, gender, and profession showed no association.

Conclusion: Most hospitalists would reportedly advise patients to receive the COVID-19 vaccine. Barriers to this recommendation included patient health status and vaccine safety. Hospitalists are an important resource to provide patient education and reduce COVID-19 vaccine hesitancy.

Keywords: COVID-19 infection; Hospital medicine; advanced practice providers; influenza vaccine; vaccine barriers; vaccine benefit.