{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T15:19:00Z","timestamp":1786375140582,"version":"build-2736575974"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-000970"],"award-info":[{"award-number":["INV-000970"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Immunisation against COVID-19 is crucial for controlling the pandemic, yet global challenges persist in vaccine coverage and equitable distribution. A well-integrated primary health care approach can enhance vaccination programmes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Aim<\/jats:title>\n<jats:p>To explore the relationship between perceived PC (primary care)-PH (public health) integration, as well as other vaccination program implementation factors, and national COVID-19 vaccination coverage.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Design and setting<\/jats:title>\n<jats:p>A convenience sample of self-identified primary care professionals completed an online survey on COVID-19 vaccination programme implementation and their perceptions of PC-PH integration.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Countries with \u22655 responses were included in the data analysis. COVID-19 vaccination implementation approach and perceived PC-PH integration against COVID-19 vaccination coverage was investigated using bivariate and subgroup analyses, Spearman correlation, and linear regression.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 394 responses from 32 countries were analysed. Participants included primary care providers, academics, and researchers. The median national COVID-19 vaccination coverage was 28.41% at time of study. Perceived barriers included patient hesitancy and vaccine supply shortages, while facilitators included vaccine product choices, equity, and community engagement. The study revealed a positive relationship between perceptions of PC-PH integration and national vaccination coverage in upper-middle and lower-middle income countries.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Perceived PC-PH integration increased with decreasing economic quartiles and this perception was linked to actual national vaccination coverage. Integration may be especially important for countries with lesser vaccine supply. High-income countries may benefit from increased collaboration between PC and PH to enhance vaccination efficiency. The findings contribute to understanding the role of PC-PH integration in vaccination programmes in different settings.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0317970","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T18:36:42Z","timestamp":1740163002000},"page":"e0317970","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Does integration matter? an international cross-sectional study on the relationship between perceived public health and primary care integration and COVID-19 vaccination rates"],"prefix":"10.1371","volume":"20","author":[{"given":"Sumeet","family":"Sodhi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rifka","family":"Chamali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devarsetty","family":"Praveen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manushi","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2117-0984","authenticated-orcid":true,"given":"Marcelo","family":"Garcia Dieguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Mash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicity","family":"Goodyear-Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0902-8520","authenticated-orcid":true,"given":"David","family":"Ponka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"pone.0317970.ref001","article-title":"COVID-19 vaccines","author":"World Health Organization","year":"2021"},{"key":"pone.0317970.ref002","article-title":"Vaccinating the world [Internet]","author":"Organization for Economic Cooperation and Development (OECD)","year":"2022"},{"key":"pone.0317970.ref003","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1038\/s41562-021-01122-8","article-title":"A global database of COVID-19 vaccinations.","volume":"5","author":"E Mathieu","year":"2021","journal-title":"Nat Hum Behav"},{"issue":"4","key":"pone.0317970.ref004","article-title":"COVID-19 Vaccine Challenges in Developing and Developed Countries.","volume":"14","author":"H Yarlagadda","year":"2022","journal-title":"Cureus"},{"key":"pone.0317970.ref005","article-title":"Immunization Agenda 2030: A global strategy to leave no one behind","author":"World Health Organization","year":"2020"},{"key":"pone.0317970.ref006","unstructured":"World Health Organization and the United Nations Children\u2019s Fund (UNICEF). 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