Park Jeongyoung, Didden Annie, Bazemore Andrew W, Jabbarpour Yalda, Seliby-Perkins LaTasha
Robert Graham Center for Policy Studies in Family Medicine and Primary Care, American Academy of Family Physicians, Washington, DC, USA.
Davidson College, NC, USA.
J Prim Care Community Health. 2025 Jan-Dec;16:21501319251356376. doi: 10.1177/21501319251356376. Epub 2025 Jul 17.
INTRODUCTION/OBJECTIVES: Vaccination rates in the United States have seen a concerning decline in recent years. Primary care, as the front line of healthcare for most individuals, is critical in reversing this trend. This study investigates trends in vaccine delivery amongst healthcare providers before and after Coronavirus Disease 2019 (COVID-19).
The delivery of vaccinations were enumerated by provider type using a combination of 2017 to 2021 Medicare Part B Fee-For-Service claims and the 2013 to 2021 Medical Expenditure Panel Survey (MEPS).
Our findings reveal a notable decline in primary care physician (PCP)-administered vaccinations, with mass immunizers and non-physician providers increasingly assuming this role. Medicare claims showed that the vaccine delivery by PCPs decreased over time, from 46.2% in 2017 to 32.3% in 2021, while the vaccine delivery by mass immunizers increased over time, from 45.2% in 2017 to 60.5% in 2021. Similarly, MEPS data showed that PCPs accounted for 53.6% of vaccination visits in the pre-pandemic period but only 22.9% during the pandemic.
The COVID-19 pandemic profoundly disrupted vaccine delivery, reshaping the roles of PCPs and other providers. This study highlights the need to better integrate primary care into future vaccine distribution frameworks to ensure broad and equitable access in the post-pandemic era.
引言/目标：近年来，美国的疫苗接种率出现了令人担忧的下降。初级保健作为大多数人医疗保健的第一线，对于扭转这一趋势至关重要。本研究调查了2019年冠状病毒病（COVID-19）前后医疗服务提供者的疫苗接种趋势。
利用2017年至2021年医疗保险B部分按服务收费索赔数据和2013年至2021年医疗支出面板调查（MEPS），按提供者类型对疫苗接种情况进行了统计。
我们的研究结果显示，初级保健医生（PCP）进行的疫苗接种显著下降，大规模免疫接种者和非医生提供者越来越多地承担起这一角色。医疗保险索赔数据显示，PCP进行的疫苗接种随时间下降，从2017年的46.2%降至2021年的32.3%，而大规模免疫接种者进行的疫苗接种随时间增加，从2017年的45.2%增至2021年的60.5%。同样，MEPS数据显示，在大流行前时期，PCP占疫苗接种就诊的53.6%，但在大流行期间仅占22.9%。
COVID-19大流行严重扰乱了疫苗接种，重塑了PCP和其他提供者的角色。本研究强调需要更好地将初级保健纳入未来的疫苗分发框架，以确保在大流行后时代广泛和公平地获得疫苗。
