Ashley Willie

Addressing Pediatric Vaccine Hesitancy: The Use of a Vaccine Hesitancy Screening Tool on Modifying Provider Communication and Education

Background: Vaccine hesitancy contributes to 1.5 million preventable deaths each year worldwide. Evidence demonstrates the essential role of family physicians and nurse practitioners delivering tailored patient/family communication and education to address barriers in parental vaccine acceptance.

Local Problem: Within a local children’s hospital health system’s primary care network, providers do not know their patients’ caregivers’ hesitancy toward vaccination; therefore, it was impossible to adjust practice behaviors (communication and/or education) without knowledge of parental attitudes.

Methods: This evidenced-based practice project was conducted in one primary care office in Pennsylvania among caregivers (of children 1 – 24 months of age) and physician providers. The pilot project implemented the Parents Attitudes About Childhood Vaccines (PACV) survey to quantitatively measure caregivers’ vaccine hesitancy and included the directed delivery of caregivers’ scores to providers. Interventions: Three interventions were implemented among 19 caregivers and three physicians at the primary care office: (1) facilitation of caregivers’ completion of the PACV via telephone before the next scheduled well child visit, (2) communication of the results of the parents’ PACV to the physicians directly before the scheduled well child visit, and (3) facilitation of 1:1 interviews with physician providers immediately after the well child visits to determine if providers changed their approaches to communication or education knowing the caregivers’ PACV results.

Results: Across the three providers’ well child visits for four weeks, 73 caregivers met project inclusion criteria. Among the 73, 39 (53%) caregivers were able to be contacted. Nineteen (48.7%) caregivers expressed interest and completed the PACV tool before their children’s next scheduled well child visits. The mean PACV score among all caregivers was 16.8 (range 0-93). 89% (n=17/19) of caregivers were identified as “low” (PACV score 0-49), and 11% (n=2/19) identified as “extreme” hesitancy (PACV score 70-100). Providers reported more instances of “no change” to communication or education (n=X, 58%) after learning caregivers’ vaccine hesitancy scores.

Conclusions: This project demonstrates pilot feasibility of implementing the PACV in a primary care practice setting; however, there is a need to continue exploration in this area to expand the number and diversity of caregivers to better understand the implications on providers’ practices. Future implications include tailored caregiver education and provider-based communication training programs.

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