Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee

Orenstein, Walter A.; Gellin, Bruce G.

doi:10.1177/003335491513000606

Cited by 95 publications

(29 citation statements)

References 57 publications

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“…Immunization has resulted in a dramatic decline in morbidity and mortality caused by infectious disease [1, 2]. Yet, there is an increasing rate of vaccine hesitancy in the United States (U.S.), with more parents requesting delayed immunization schedules or withholding from vaccinating their children altogether [1, 3, 4]. Additionally, vaccine hesitancy is not only present in the general population, but present in healthcare professionals (HCPs) and has been shown to influence their vaccine-related behavior and decisions [5–15].…”

Section: Introductionmentioning

confidence: 99%

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Immunization attitudes, opinions, and knowledge of healthcare professional students at two Midwestern universities in the United States

2019

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Background In addition to administering vaccinations, healthcare professionals (HCPs) also play a crucial role in providing education and advocacy to the public regarding immunizations. Yet, many current and future HCPs are unprepared or reluctant to address the vaccine conversation with hesitant patients. Doctors, pharmacists, and nurses are all recognized as the most trusted sources of vaccine information. By comparing future HCPs in these three distinct programs, we can better understand where potential gaps may lie in their training and education. With insight from students, potential changes to curriculum can improve future HCPs ability to address vaccine hesitancy in their respective careers. The objective of this study was to assess and compare the knowledge, attitudes, and opinions of HCP students on the topic of immunization. Methods A cross-sectional survey was conducted in 2017 to assess students in nursing, medical, and pharmacy programs at two universities in the state of North Dakota in the United States. The survey assessed six key themes: 1) demographic information; 2) basic vaccine knowledge; 3) vaccine hesitancy; 4) likelihood to recommend vaccines; 5) confidence in addressing vaccine-related topics with patients; 6) an appraisal of the education they have received on vaccinations. Results The survey was completed by 223 participants (overall response rate = 23.7%). Results indicated that vaccine-related knowledge varied greatly by program; high knowledge scores were achieved by 74.3% of medical students, 62.7% of pharmacy students, 57.1% of doctor of nursing practice (DNP) students, and 24.7% of bachelor of science in nursing (BSN) students. Over a third (34.2%) of BSN students believed that the current recommended immunization schedule places undue burden on a child’s immune system, versus only 4.3% of medical students. Additionally, 54.2% of participants believed that spreading out recommended vaccines over several visits was an appropriate means of reducing parental stress about vaccinating. Conclusions Participant responses suggest that negative attitudes, lack of knowledge, and general discomfort exist across all programs, but especially among nursing students, regarding vaccination. Our findings indicate potential areas where targeted interventions could be implemented to better equip future HCPs in their ability to discuss and educate the public regarding vaccination. Trial registration #PH17173 Electronic supplementary material The online version of this article (10.1186/s12909-019-1678-8) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

“…These findings are particularly alarming as HCPs are considered to be the most significant influence and the primary source of information for patients and caregivers regarding vaccines [1, 5, 9, 16–19]. Patient trust in their HCP is often associated with their ultimate decision of whether to accept or decline vaccines [4, 9, 18].…”

Section: Introductionmentioning

confidence: 99%

Immunization attitudes, opinions, and knowledge of healthcare professional students at two Midwestern universities in the United States

2019

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“…Developing and evaluating interventions to counteract parental vaccine hesitancy and childhood undervaccination is a public health priority 6. While many prior interventions have been tested, the majority have not been effective 7–9.…”

Section: Introductionmentioning

confidence: 99%

‘Reducing Delays In Vaccination’ (REDIVAC) trial: a protocol for a randomised controlled trial of a web-based, individually tailored, educational intervention to improve timeliness of infant vaccination

et al. 2019

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IntroductionIncreasing numbers of children are failing to receive many recommended vaccines, which has led to significant outbreaks of vaccine-preventable diseases in the USA and worldwide. A major driver of undervaccination is parental vaccine hesitance. Prior research demonstrates that mothers are the primary decision maker for infant vaccination, and that their vaccination attitudes form primarily during pregnancy and early in their infant’s life.Methods and analysisThis manuscript describes the protocol for an ongoing three-armed randomised controlled trial done at Kaiser Permanente Colorado (KPCO). The trial aims to test the efficacy of provided tailored, individualised information via the Internet to pregnant and new mothers versus untailored information versus usual care on the timeliness of infant vaccination. The primary outcome to be assessed is vaccination status, which is a dichotomous outcome (up to date vs not) assessed at age 200 days, reflecting the time when infants should have completed the first set of vaccine provided (at age 2, 4 and 6 months). Infants with one or more age-appropriate recommended vaccines at least 30 days delayed are categorised as not up to date whereas all other infants are considered up to date. Secondary outcomes include vaccination status at age 489 days, reflecting receipt of recommended vaccines at age 12–15 months, as well as vaccination attitudes, hesitancy and intention. Vaccination data will be derived from the electronic medical record and the state immunisation registry. Other secondary outcomes will be assessed by online surveys.Ethics and disseminationThe study activities were approved by the Institutional Review Boards of the University of Colorado, KPCO and the University of Michigan. Results will be disseminated through peer-reviewed manuscripts and conference presentations.Trial registration numberNCT02665013; Pre-results.

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“…The proliferation of online misinformation about vaccines is an example of how the immunization landscape has transformed since the release of the last NVP in 2010. 8 The World Health Organization (WHO) recognized vaccine hesitancy as one of the top 10 global health threats in 2019, stating that these threats have the potential to reverse progress made against vaccine-preventable diseases. 9 At the June 2019 NVAC meeting, HHS Secretary Alex M. Azar II made vaccine confidence an HHS priority, remarking that "one of the most pressing public health challenges our country faces is vaccine hesitancy, driven in part by misinformation."…”

Section: Introductionmentioning

confidence: 99%

2020 National Vaccine Plan Development: Recommendations From the National Vaccine Advisory Committee

2020

Public Health Rep

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Executive SummaryThe National Vaccine Plan (NVP) 1 serves as a roadmap for the 21st-century vaccines and immunization enterprise. Mandated by Congress in 1987, the NVP has provided the nation with a comprehensive strategy for enhancing all aspects of vaccination for more than 30 years. The most recent version of the plan was released in 2010. As the immunization landscape and vaccination system continue to evolve, the US Department of Health and Human Services (HHS) intends to release an updated NVP in 2020. The plan will encompass a lifespan approach, covering vaccination from before birth into old age, to immunization policy and practice for the next 5 years.To support this effort, the Assistant Secretary for Health (ASH) charged the National Vaccine Advisory Committee (NVAC) on March 25, 2019, with developing a report and recommendations to guide the development of the updated NVP. The charge called on NVAC to assess the relevance of existing plan goals, integrate adult immunization goals, prioritize the top objectives within each goal, and identify stakeholders for engagement in the plan's development.In response to this charge, NVAC established the NVP Development Subcommittee, which comprised NVAC members, several persons from the private sector with relevant expertise, and HHS staff members. The recommendations in this report will be part of a rigorous process used to inform the final plan, which the HHS Office of Infectious Disease and HIV/AIDS Policy (OIDP) will release in 2020.After careful assessment of the current NVP, the National Adult Immunization Plan (NAIP), 2 and midcourse reviews conducted by HHS 3 and NVAC 4 of the NVP, the subcommittee developed recommendations in support of a 5-year plan that reflects immunization priorities across the lifespan (Table 1). These recommendations include changes to each goal, as well as identifying the top 3 priorities poised to make the greatest impact within each goal. To complete the charge from the ASH, NVAC also recommended stakeholders to engage during development of the NVP (Recommendations 2-5). The NVAC recommendations in this report will provide a strong foundation for the development of the 2020 NVP.

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Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee

Cited by 95 publications

References 57 publications

Immunization attitudes, opinions, and knowledge of healthcare professional students at two Midwestern universities in the United States

Immunization attitudes, opinions, and knowledge of healthcare professional students at two Midwestern universities in the United States

‘Reducing Delays In Vaccination’ (REDIVAC) trial: a protocol for a randomised controlled trial of a web-based, individually tailored, educational intervention to improve timeliness of infant vaccination

2020 National Vaccine Plan Development: Recommendations From the National Vaccine Advisory Committee

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