Addressing COVID-19 Vaccine Acceptance Within a Large Healthcare System: a Population Health Model

Background The COVID-19 pandemic, and vaccine hesitancy, pose a significant public health threat. The Veterans Health Administration system is uniquely situated to provide insights into the implementation of a population health approach to vaccine acceptance. Aim We describe the VA Connecticut Healthcare System’s (VACHS) quality improvement project to improve rates of vaccine uptake. Setting and Participants VACHS consists of eight primary care sites with 80 primary care providers delivering care to 47,000 enrolled veterans. Program Description Our program involved identification of a local champion, education sessions, development of vaccine acceptance tools (including the templated “COVID-19 Prevention Letter” and the “COVID-19 Prevention Telephone Note”), and application of a population health approach (use of a prioritization scheme and playbook) by primary care patient-aligned care (PACT) medical home teams. Program Evaluation We found increased rates of vaccination at VACT compared to the surrounding region 6 months after implementation (65.16% vs 61.89%). Use of vaccine acceptance tools were associated with a statistically significant increase in vaccination (24.1% vs 13.6%, P = 0.036) in unvaccinated veterans. Discussion A population health approach to vaccine acceptance using EHR-based tools can impact vaccination rates, and this approach may be of practical utility to other large healthcare systems with EHR.