Strengthening Vaccine Confidence and Acceptance in the Pediatric Provider Office

Abstract

Although vaccine acceptance and uptake are overall high among children in the United States, vaccine delays or refusals are a growing concern. Vaccine hesitancy is a challenge for the pediatric provider, given the diverse factors associated with hesitancy and the limited evidence on effective strategies for addressing vaccine hesitancy in the provider office. In this article, we review available evidence and approaches for vaccine communication, including the importance of using a whole-team approach, building trust, starting the conversation early, using a presumptive approach for vaccine recommendations, motivational interviewing with parents who have concerns for vaccines, and additional techniques for responding to parent questions. We also review organizational strategies to help create a culture of immunization in the practice, including evidence-based approaches for increasing vaccine uptake and efficiency. Although these communication approaches and organizational strategies are intended to reassure parents who are vaccine hesitant that all routine, universally recommended vaccines are safe and effective, they likely will take on increased significance as the development, implementation, and evaluation of coronavirus disease 2019 vaccines continue to unfold. [ Pediatr Ann . 2020;49(12):e523–e531.]

Increasing Coronavirus Disease 2019 Vaccine Uptake in Pediatric Primary Care by Offering Vaccine to Household Members

“…We hypothesized that household members would consider receiving the vaccine in the pediatric primary care center, as the pediatric office serves as a trusted, convenient space for treatment and information. ( 13 ) Thus, we designed our system to have COVID-19 vaccine available and offered to all eligible household members from the inception of our vaccination program on May 13, 2021. This system created opportunities for pediatricians to counsel household members about the COVID-19 vaccine and address relevant concerns, even when the patient being seen for the visit was not yet eligible (e.g., an infant’s parent).…”

Vaccine Hesitancy: Drivers and How the Allergy Community Can Help

“… 58 , 59 Many of these interventions and strategies focus on supporting successful provider-patient communication about vaccines and building a culture of immunization support through practice-level activities and systems. 60 …”

“…Practice-level interventions can address issues such as complacency and access, which may contribute to undervaccination. 10 Mbaeyi et al 60 demonstrated the importance of vaccination to patients by creating a practice culture that values on-time vaccination, contributing to positive social norms around vaccination. Practice-level interventions include strategies like assessment and feedback, 68 so that providers are aware of their practice-level vaccination rates and can focus their attention on areas of low coverage, reminder-recall systems to prompt patients to return for due or missed vaccines, 69 and standing orders to maximize opportunistic vaccination.…”

“… 70 Other strategies, such as making vaccine information easy to find at the health care facility or proactively sharing the clinic's policy on vaccination, can help foster a culture of immunization support that reinforces the importance of vaccination to all. 60 …”

Trust about corona vaccine among health professionals working at Dilla University referral hospital, 2021

“…Health care providers have hesitancy towards the safety, effectiveness and continuity of corona vaccine especially among youths, females and pediatric service providers [12] , [13] , [14] . On the contrary, those health care personnel with previous history of flu/ influenza vaccine, chronic medical illness and advanced work experience had willingness to get the vaccine [15] , [16] , [17] .…”