Shifting Patterns of Vaccine Delivery Before and After COVID-19: The Declining Role of Primary Care.

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).

Methods: 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).

Results: 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.

Conclusions: 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.