Types of primary care visits and COVID-19 vaccine hesitancy: a retrospective cohort study

BACKGROUND: The COVID-19 pandemic changed the nature of primary care visits, from face-to-face to an increasing prevalence of online or telephone visits, but little is known about the association between types of primary care visits and vaccine hesitancy. AIM: To examine the association between primary care visit type and COVID-19 vaccine hesitancy. DESIGN AND SETTING: A retrospective cohort study for the period of 9.2019 to 9.2022 was conducted using randomly selected medical records from a large HMO on adults with at least one visit with the primary care physician between 1.12.2019 to 30.11.2020 (the exposure period). METHOD: Logistic regression models were used to test the association between primary care visit type and full COVID-19 vaccination status after adjusting for socio-demographic, clinical, and health behaviour characteristics. RESULTS: Of the final cohort (n = 173 779), 126 204 (72.6%) were fully vaccinated. Logistic regression model findings indicated that male adults who used online asynchronous visits, lived in a city, had hypertension and/or diabetes, and received seasonal influenza vaccine were more likely to obtain full vaccination. Less likely to obtain full vaccination were adults who used telephone visits, had high numbers of face-to-face visits, had low socioeconomic status and were ≥60 years old (P<0.001 for all). CONCLUSION: Primary care visit type during the COVID-19 pre-vaccination period predicts vaccine hesitancy. Physicians' awareness of patients who avoid using newer forms of technology-based visits, may allow the provision of targeted interventions to improve health outcomes.