Post on 30-May-2020
State/Local/Territorial Immunization Program Vaccine Hesitancy/Confidence/Safety
Activities-Lessons Learned- Recommendations
Katelyn Wells PhD
AIM Research Coordinator
AIM Best Practice Webinar 6/17/2014
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Objectives
Understand IP priority level for addressing Vaccine Hesitancy/Confidence/Safety (VHCS)
Provide examples of IPs VHCS activities
Review top challenges and successes
Review IP recommendations to NVAC to help support state/local efforts (not official AIM recommendations)
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Methods: Information Gathering
2013 AIM Annual Survey – Preliminary Results (open 1/2014-3/2014)
AIM VHCS Survey and follow-up emails (open 3/31/2014-4/8/2014)
AIM VHCS Webinar – 3/12/2014
AIM VHCS Peer-to-Peer Sharing Call – 9/29/2013
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No Response
(13%, N=8)
Not a priority Moderate priority Low priority
(1%, N=1) (28%, N=18) (13%, N=8) (31%, N=20)
High Priority Essential Priority
(14%, N=9)
Immunization Program Priority Level for Addressing
Vaccine Hesitancy/Confidence - CY2014
2013 AIM Annual Survey – Preliminary Results 4
Cities / Metropolitan Areas Territories Chicago American Samoa
District of Columbia Guam
Houston Republic of Marshall Islands
New York City Federated States of Micronesia
Philadelphia Northern Mariana Islands
San Antonio Palau
Puerto Rico
Virgin Islands
Immunization Program Priority Level for Addressing
Vaccine Hesitancy/Confidence - CY2014
Cities / Metropolitan Areas &Territories
No Response
(13%, N=8)
Not a priority Moderate priority Low priority
(1%, N=1) (28%, N=18) (13%, N=8) (31%, N=20)
High Priority Essential Priority
(14%, N=9)
2013 AIM Annual Survey – Preliminary Results 5
Immunization Program Priority Level for Addressing
Vaccine Hesitancy/Confidence - CY2014
No Response
(13%, N=8)
Not a priority or low priority
(14%, N=9)
Moderate to Essential Priority
(73%, N=47)
2013 AIM Annual Survey – Preliminary Results 6
Low priority Moderate priority High Priority Essential Priority
2013 AIM Annual Survey – Preliminary Results
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No
Response
VHCS Only
VHCS Survey
Response Only Moderate priority Low priority
(3 of 18; 17%) (3 of 8; 38%) (8 of 20; 40% )
High Priority Essential Priority
(8 of 9; 88%)
2013 AIM Annual Survey – Preliminary Results & AIM VHCS Survey Results 8
IP responding to AIM VHCS Survey by Priority Level for Addressing
Vaccine Hesitancy/Confidence - CY2014 (24 of 64; 38%)
Puerto Rico
Guam
American Samoa
San Antonio
(2 of 8; 25%)
9 AIM VHCS Survey Results - 3/31/2014-4/8/2014
Program Activities: VT Tailored Mass Media Campaign
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“It’s Ok to Ask”
Campaign Contracted with a marketing group
Reviewed key research findings
Held focus groups
Worked with local pediatricians to create a “Vermont” feel www.oktoaskvt.org
YouTube
Face Book
TV Ads
Posters
Present information in a way that parent’s fears and concerns are addressed and acknowledged
Create a brand that is positive, approachable and transparent
Provide audience with the information they need via the channels they use
Provide healthcare professionals effective tools
Campaign Strategy:
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Lessons Learned
Model great for gathering different perspectives
Neutral, 3rd party facilitator important
- Importance of available funding to conduct activity
Invite your opposition (but beware)
Steering Committee/Stakeholders should be mutually exclusive
Program Activities: CO Stakeholder Engagement Process
Gain a better understanding of the current state of PBE attitudes and opinions
Meaningfully participate in facilitated in-depth discussions on current PBE policies and practices
Generate potential policy and/or rule changes to the PBE system.
Make final recommendations to be formally submitted to CDPHE in a written report.
Goals
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Connecticut Immunization Registry and Tracking System (CIRTS) captures vaccine refusals
From drop down field - select which vaccine(s) were refused
CIRTS is capable to run a report on vaccine refusals by provider or by Zip Code
CT plans to run these reports in the future
11 Immunization Action Plan (IAP) Coordinators located throughout the state
Target areas of need and conduct outreach
Work closely with the provider offices
Program Activities: CT Capturing Vaccine Refusal in IIS
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New Hampshire staff address vaccine confidence at provider site visits (VFC/AFIX or VFC-only)
Issue is prompted by required CDC site-visit question "Do your health care providers follow the current ACIP routine immunization schedule?"
Provides an opportunity for discussion about: delayed vaccination schedules vaccine hesitant parents how the practice documents vaccine refusals why a delayed vaccination schedule is not recommended
Provides resources: Current Childhood, Adolescent, Adult Immunization schedules Revised Standards for Childhood/Adolescent Immunization Practices Links to web-based resources (Needle tips, etc.)
Program Activities: NH Addressing VHCS at Provider Site-visits
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School exemption form captures parental reasoning for claiming religious and philosophical exemptions
This information is collected and maintained by schools Information was collected and shared with healthcare providers during the
annual Shot Smarts immunization conference -2011 (not routinely collected)
Parent focus groups to assess views Created “Dear Doc” videos
Shot Smarts immunization conferences
Website and Facebook page
Program Activities: ID Assessing Vaccine Refusal and Developing Targeted Approaches
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Established a partnership, called Vax Northwest, to address vaccine
hesitancy http://www.vaxnorthwest.org/
Created a toolkit for providers to support them engaging in
conversations with parents who are hesitant to vaccinate
Created the AAA Approach
Training Videos
Conversation Guide
Literature
Common Questions About
Immunizations fact sheet
Program Activities: WA Partnering to Educate Providers
Lessons Learned: Successes
Partner/Collaborative Approach Partnering with Coalitions (NV; MN; WV; HI; PR)
Task Force (WV)
Partnering with AAP (MA; NC; RI; IA; HI )
Stakeholder Process of Exemption (CO)
Partnering and Community Events (Guam)
Improved Legislation or Policy (VT; OR; WA; NY)
HPV Grant Funding (NY)
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Lessons Learned: Successes
Assessment/Reporting
Identifying VCHS clusters and working with the schools (LA)
IZ Annual Report (VT)
IIS (CO; ID)
Research Project (OR)
Providing quarterly coverage rates (ME)
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Lessons Learned: Successes
Education
Provider Education (NV; WA; PR; NV; SA; RI; WV; ME)
Peer - Parent Education (WA)
Targeted Public Education Campaigns (MN; NC)
Web - Based Tactics/Campaign (VT; ID; PR)
Annual Provider Conference (ID; WY)
Education Materials to Schools & Daycare Facilities (ID)
Educating Parents Before Vaccination & Following - up With Parents After Vaccination (Amer. Sam.)
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Lessons Learned: Challenges
Legislation/Policy (LA; MA; AZ; NM)
Lack of Knowledge Scope of VHCS Among Parents and Providers (NY)
Parent Focus (PR; Amer. Sam.)
Communication Connecting Parents With Reliable Resources/Wrong Information
(SA; RI; HI; PR; WY; NC; ID)
Provider Communication Style/Time/Hesitancy
(WV; NC; NM; PR; WA; MN)
State - Based Media Communications - Marketing (LA; MN; MA)
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Lessons Learned: Challenges
Resources Rural nature and accessing providers a challenge (e.g., transportation) (WA)
Funding (NV; RI; OR; WY)
Lack of Coalition (Guam)
Lack of Support from Child-Care Agency (VT; NM )
Targeted Groups Adolescents (NV)
Refugee Populations – low rates (WA)
Anti- Movement Increase of Alternative Schedules (MN; OR; WA )
Anti-vax Group (VT; CO; OR; WA; PR)
Distrust in Government (ID; RI)
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Unofficial AIM Recommendations to NVAC
Encourage strengthened school exemption laws
Encourage a coordinated national campaign addressing VHCS issues and highlighting the importance of timely immunizations
Encourage research efforts that addresses how state/local/territorial health departments can effectively address vaccine hesitancy/safety – Provider & Population Level
Explore if and how VHCS (provider and patient) can be formally incorporated into IP provider site visits
Encourage the expansion of Immunization Information Systems (IIS) to capture vaccine refusal and exemptions
Encourage ongoing funding opportunities to support IP: venues for training/education & resources to plan, execute and maintain a targeted VHCS campaign
Dr. Melinda Wharton – 3/27 AIM General Membership Call 22
“The rhetoric is out of proportion to the extent
of the problem. It threatens understanding
that it is normative behavior to be vaccinated.”
State/Local/Territorial
IP
Providers
Immunization Organizations & Coalitions
Federal Agencies
Parent Groups
Researchers
Provider Organizations
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Katelyn Wells, PhD
AIM Research Coordinator
615-469-5486
kwells@immunizationmanagers.org
WWW.IMMUNIZATIONMANAGERS.ORG
@AIM_IZ