Communication support for childhood vaccines: Evaluating CDC’s “Provider Resources for Vaccine Conversations with Parents” materials

Theoretical Background and research questions/hypothesis:

Recommended childhood vaccines prevent significant morbidity, mortality, and healthcare costs. While state-level school-entry laws help ensure high vaccine coverage in the United States, uptake of vaccines is ultimately dependent on parent acceptance. Healthcare professionals (HCPs) have routinely been cited as the most trusted source of vaccine information for parents, regardless of a parent’s attitudes toward or plans for vaccination. However, HCPs have reported a significant professional burden in responding to vaccine hesitancy, delay, and refusal. The objectives of this research were to:

• Explore the process of selection, adoption, dissemination, and utility of childhood and adolescent communication materials in healthcare settings.
• Explore perceptions of immunization conversations with physicians, values related to vaccine decision making, and reactions to messages and materials among parents of children under age 2.

Methods:

CDC conducts ongoing mixed method research with parents and HCPs in order to better support these audiences in vaccine communication. In 2018, we conducted an online survey of parents of young children (n=2,506) and focus groups with a total of 151 mothers in three US cities. We also completed an environmental scan, including a review of past CDC communications research, and a mixed-method survey and interview study of physicians who used selected CDC communication materials in practice (n=77), in order to evaluate the “Provider Resources for Vaccine Conversations with Parents” materials.

Results:

Parents reported trust in several sources of vaccine information, including HCPs, family, friends, and online searches. Most were satisfied with past vaccine discussions with their child’s HCP, although some reported feeling rushed into the decision to vaccinate. HCPs recognized the importance of their communication with parents regarding vaccines, but often reported frustration in routinely dealing with vaccine hesitancy and misinformation. HCPs do not actively seek out general vaccine content, but instead search for answers to specific questions or use materials that are pushed out to them. They are most likely to use materials with new parents and parents who have questions or are “on the fence”, and they don’t want to overwhelm parents with too much information. Few HCPs shared educational information electronically with parents via email, patient portals, or social media.

Conclusions:

Strategies such as empowering support staff to discuss vaccines before the patient sees the provider, providing information early in the vaccination process, discussing local disease outbreaks, and letting parents know that they also vaccinate their own children were considered successful ways to communicate the importance of vaccines with hesitant parents. CDC messages and materials were well-received, particularly those that were visually engaging, concise, and offered time-saving strategies for HCPs.

Implications for research and/or practice:

Discussions about vaccines need to begin early, and materials for parents should be concise and visually appealing. They should contain information that answers common parent questions, thereby helping HCPs to save time during vaccine conversations. Increasing the capacity of HCPs and other office staff to communicate with vaccine hesitant parents could also help alleviate HCP frustration and improve parent satisfaction with vaccine discussions.