A study that examined how Ontario patients reacted to COVID-19 vaccines identified those individuals who were less likely to get the vaccine, and how family doctors play a part in vaccine uptake.
"Patient characteristics associated with not being vaccinated included younger age, having less comorbidity (other illnesses), being male, living in low-income neighbourhoods, and living in neighbourhoods with high ethnic diversity," said the study.
The study found that patients who accepted and trusted vaccine advice were usually those who had family doctors who were able to communicate well and debunk misinformation.
The research was recently published in the Canadian Medical Association Journal and was based on information from more than 9,000 family physicians with more than 10 million enrolled patients.
The study was researched and written by 19 physicians and scientists associated with hospitals and university health research centres in Toronto, Hamilton, Kingston, Calgary and Quebec City.
The study said it assessed the characteristics of family physicians with the largest proportion of unvaccinated patients, aged 12 and older.
The study said it was able to define "the 10 per cent of physicians who had the highest proportion of unvaccinated patients in their practices, knowing that future efforts to support primary care practices in achieving public health priorities would need to focus on those with the greatest opportunity for improvement."
The characteristics of that group of physicians was outlined in the article.
"Family physicians with the largest proportion (top 10 per cent) of unvaccinated patients were more likely to be male, to have trained outside of Canada, to be older, and to work in an enhanced fee-for-service model than those in the remaining 90 per cent.”
The article also reported that the largest proportion of unvaccinated patients were from "marginalized communities" and were less likely to use team-based primary care health models, meaning their primary care provider may have had fewer support staff in their clinics.
"These findings can guide resource planning and help tailor interventions to integrate public health priorities within primary care practices," said the study.
"Among people in Canada, concerns about risks and adverse effects are the top reasons for non-intent to receive a SARS-CoV-2 vaccine," said the article.
"These trends are most commonly observed among communities that have low levels of trust and confidence in government because of deep histories of marginalization by institutions and harm, including being subjected to unethical medical procedures and experimentation," the article continued.
The article reported that family doctors were important in being able to provide key information to their patients.
“Family physicians can play an important role in increasing vaccine uptake through building vaccine confidence and debunking misinformation among their patients, as many people in Canada consider family physicians as their most trusted source of vaccine information,” said the article.
The authors wrote that patients with no attachment to primary care providers likely represented the greatest public health priority, during the pandemic and beyond.
They said their work had limitations because it was based on data from patients who already had family doctors.
"Our analysis of patient and physician characteristics was limited to administrative databases. Aside from the inability to measure many social determinants of health, psychological factors, and beliefs, which are all known to be associated with vaccine uptake, the most notable limitation of this study is that our analyses were limited to patients that were attached to a family physician," said the study.
In conclusion, the authors wrote that family physicians in Ontario who cared for the largest proportion of unvaccinated patients had distinct patterns that may represent opportunities for targeted interventions in the future.
"Overall, these physicians tended to serve patients living in marginalized neighbourhoods and were less likely to work in team-based models of care. More equitable resource allocation, specifically expanding primary care teams in equity-seeking neighbourhoods, should be considered when supporting primary care practices with public health efforts," said the study.
The full text of the CMAJ study can be found online here.