{"id":49724,"date":"2021-03-03T17:13:54","date_gmt":"2021-03-03T16:13:54","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=49724"},"modified":"2021-03-08T12:23:40","modified_gmt":"2021-03-08T11:23:40","slug":"let-primary-care-providers-vaccinate-their-patients-against-covid-19","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/03\/03\/let-primary-care-providers-vaccinate-their-patients-against-covid-19\/","title":{"rendered":"Let primary care providers vaccinate their patients against covid-19"},"content":{"rendered":"

The pandemic has upended the role of primary care providers in the US, but putting them at the heart of the vaccine rollout would help to restore their place, writes Eric Kutscher<\/p>\n

As a primary care doctor in New York City, I\u2019ve spent the past year unable to help my patients during the time they\u2019ve needed me the most. As SARS-CoV-2 swept across the city last March, my outpatient office closed as I was redeployed to inpatient services to help care for those with <\/span>covid-19 pneumonia. When I was finally able to see my regular patients again months later, I witnessed the pandemic\u2019s toll on them: worsened control of diabetes, higher blood pressure, alarming problem<\/span>s with weight management, and devastating new cases of depression. I was pained by the loss of several of my patients to<\/span>\u00a0<\/span>covid-19 itself, and bore witness to the suffering of those continuing to struggle with<\/span> long term complications from their infection.\u00a0<\/span><\/p>\n

The pandemic has upended the ways primary care providers like me are able to routinely care for<\/span> our patients. Many <\/span>primary care offices across the US<\/span><\/a> have shuttered due to the risk of <\/span>covid-19 transmission to providers and office staff, decreased patient interest in seeking \u201cnon-essential\u201d medical care, and <\/span>difficulty with reimbursements for telemedicine visits<\/span><\/a> compared with in-person visits. <\/span>It\u2019s ironic<\/span>\u00a0that while research has unequivocally shown <\/span>covid-19 causes worse outcomes in people with <\/span>pre-existing conditions like <\/span>diabetes<\/span><\/a> and <\/span>hypertension<\/span><\/a>, our singular focus on managing<\/span> the virus has allowed for the <\/span>worsening<\/span><\/i> of these conditions, and increased the risk of morbidity and mortality among those infected.\u00a0<\/span><\/p>\n

When the <\/span>Pfizer<\/span>-BioNTech<\/span><\/a> and <\/span>Moderna<\/span><\/a>\u00a0covid-19 vaccines first became available here in New York, I tried to help my eligible patients secure appointments. Yet my patients and I were<\/span>\u00a0<\/span>frustrated by hours of waiting on hold, <\/span>a decentralized patchwork of websites, limited appointment availability at nearby sites, and last <\/span>minute cancelations due to supply shortages. <\/span>This life saving shot still remained mostly out of reach for my patients. In the meantime, I had to hold off on prescribing all other vaccines for healthcare maintenance, as individuals <\/span>are not allowed to have received another shot within two weeks of their covid-19 vaccine<\/a>\u2014if they have,<\/span> they are often deemed ineligible.\u00a0<\/span><\/span><\/p>\n

The US should <\/span>return <\/span>covid-19 care to primary care providers. And the <\/span>Johnson & Johnson vaccine<\/span><\/a>, which has been recently approved by the US Food and Drug Administration,<\/span> is the perfect vaccine <\/span>to do just that. It\u2019s a single shot, and doesn\u2019t require special storage temperatures\u2014<\/span>unlike the vaccines from Pfizer-BioNTech and Moderna. The vaccine <\/span>can therefore be easily distributed at almost any primary care clinic nationwide. <\/span><\/p>\n

Having a tool to help protect my patients from <\/span>covid-19 will help re-engage them<\/span> in other areas of their care: those who are looking for a vaccine will return to clinics for an appointment, and can get overdue refills for medications and manage their chronic medical problems. Vaccine distribution through primary care providers will help <\/span>invest in our pre-existing structures for healthcare, rather than bypass them<\/span><\/a>. And, as the likelihood of an <\/span>annual booster shot<\/span><\/a> for covid-19 becomes more of a reality, incorporating covid-19 vaccination into the site where all other vaccinations occur is the logical next step.\u00a0<\/span><\/p>\n

It\u2019s time we move away from covid-19 exceptionalism where this novel viral phenomenon is treated separately from the remainder of medicine. Covid-19 has been here for a year\u2014and for the foreseeable future, it\u2019s here to stay. To <\/span>best manage covid-19, we must integrate prevention and treatment efforts into primary care. A holistic approach to health and investment in our medical system is <\/span>long overdue. <\/span>\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/p>\n

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Eric<\/span>\u00a0Kutscher<\/strong>\u00a0is an internal medicine physician in New York City with a passion for addressing health disparities. Twitter\u00a0@ekutscher<\/a><\/em><\/p>\n<\/div>\n<\/div>\n<\/blockquote>\n<\/div>\n<\/div>\n<\/div>\n<\/blockquote>\n<\/div>\n<\/div>\n<\/blockquote>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/blockquote>\n<\/div>\n<\/div>\n<\/div>\n<\/blockquote>\n

Competing interests:<\/strong> none declared.<\/p>\n","protected":false},"excerpt":{"rendered":"

The pandemic has upended the role of primary care providers in the US, but putting them at the heart of the vaccine rollout would help to restore their place, writes […]<\/p>\n

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