Table 6.
Summary of practice facilitators and barriers identified during focus groups of health care providers
| Facilitators | Collaborative efforts among HCPs: improving accessibility | |
| “I think the more people you can get on board to administer the Tdap vaccine, the easier access the patient will have to get it. They can book an appointment, or they can get it as a part of their routine visit, if the pharmacy starts giving it when they go pick up their monthly medications they could have it administered there, so it's not hours of waiting … .” (PEI) | ||
| “I would as long as they (pharmacists) got the appropriate training by a credited source.” (BC) | ||
| “With training for pharmacists, it's a good idea” (QC) | ||
| “So first of all there has to be an availability of the vaccine to supply the demand” (PEI) | ||
| Electronic databases and the importance of immunization tracking | ||
| “If there was an electronic record where you could go in and say: Oh look, their vaccines aren't up to date. Then it could be something you could bring up.” (PEI) | ||
| “In our clinic we are very up to date with our MMR for instance. Our RN is very good; he goes through the system and highlights the patients for each physician who is in need of vaccinations, so it is very proactive. I think with our new Pharmanet, with us giving some injections, there is now an electronic record that follows patients so that people could actually be followed through the electronic registry by their physicians as to what their immunization statuses are.” (BC) | ||
| “When I was a child in school I got all my shots so I am ok.” (ON) | ||
| “For routine immunizations adults assume it is done.” (NS) | ||
| Advocacy and education | ||
| “I think physicians need to have a role in advocacy. Their opinions to their patients are highly valued. Their recommendations sway people who are on the fence.” (QC) | ||
| “I think appropriate care would say that it's my responsibility to be aware of disease preventable adult vaccinations, with respect to travel for patients, and with respect to the Canadian and provincial recommendations for immunization “I think a lot of times if we have a good talk with the patient, they've been our patient for 10 y and they trust us and we haven't killed them yet- they often make the leap and get the vaccine-because they see us as a trusted authority figure with their best interest at heart.” (ON) | ||
| “In case of my clinic or during my physical I make it a point when I am doing physicals to ask them about immunizations.” (SK) | ||
| “I identify high risk people, like new mothers.” (NS) | ||
| Barriers | ||
| Current fee structure | ||
| “They're expensive so one of the big barriers I see is people will say: Oh yeah I could get a tetanus pertussis but it will cost me $30.00.” (BC). | ||
| “Provincially a tetanus is provided free of charge, and most people will opt for that because of the cost.” (BC). | ||
| Public/provider lack of knowledge and engagement with the Tdap vaccine | ||
| “Basically my observation on adult vaccinations is that there is a whole lot of room to go with vaccines; they're not aware of when to get boosters.” (ON) | ||
| “We need to be doing boosters … . But people don't care.” (ON) | ||
| “Tetanus, diphtheria, and what's the one on the end?” (NS) | ||
| “It has multiple tetanus, diphtheria, umm I'm not sure what's the other part, I'd have to look them up, I'm not sure what the other stand for. I'm not sure how frequently it's given, and what it is given for.” (BC) | ||
| Vaccine hesitancy | ||
| “I had a lot of people at the Community Pharmacy who would come in and ask: “Is this vaccine bad?” And I'm like well, have you ever seen somebody with this condition? I mean, you have to explain, but it's annoying, because they're more willing to agree with the easy information source rather than the right information” (SK) | ||
| “Ok, any kind of medical treatment is a personal choice, but from my standpoint there is a lot of anti-vaccine information, and I don't think that Health Canada or practitioners are doing a great job in terms of countering the myths with correct information.” (SK) | ||
| Workload | ||
| “I think that Public Health people are committed to disseminate vaccine information to the public. I am neither paid, nor do I have time to pull someone aside to say ‘Hey have you heard about this vaccine?’(PEI) | ||
| “Physicians' offices are the default primary care places for vaccines to be done. But it's inappropriate because it costs millions and millions of dollars every year; it's a waste…” (NS) | ||
| “So in writing, yes, we support the recommendations, but we're not trying to find these people, probably the vaccine, it's a catch 22. It's passive. We're not actively seeking out people to give it.” (SK). | ||