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Validating Vaccines
What’ s the most effective way to increase public confidence in vaccines?
The percentage of parents who refuse all vaccines for their children is small, roughly 3 %. There is, however, an increasing number of parents who refuse or want to defer individual vaccines or use an immunization schedule for their child that is not recommended. That’ s according to Children’ s Colorado’ s primary care pediatrician and health services researcher Allison Kempe, MD, MPH, and pediatric infectious disease specialist Sean O’ Leary, MD, MPH, who’ ve been researching vaccine hesitancy for over two decades.
Together with Children’ s Colorado, the Anschutz Medical Campus, and a myriad of local, regional and national organizations, Drs. Kempe and O’ Leary are using their research to educate parents and inform providers on how best to address a debate that, at least according to nearly everyone in the medical community, really shouldn’ t exist— but does.
PREPARING PROVIDERS
“ We’ ve had a rapid survey unit in place for over 15 years that solicits information from primary care providers, pediatricians, general internal medicine physicians and family practitioners,” says Dr. Kempe.“ We’ ve found that a majority of providers— pediatricians especially— are spending more than 10 minutes or even up to 20 minutes discussing vaccines if parents are hesitant.”
Given that an average primary care visit is around 13 minutes, that leaves little to no time for addressing other important topics like nutrition and sleep.
“ And then we go into the next visit over-remembering having just had a difficult conversation, assuming that the next parent is going to be resistant to vaccines,” says Dr. O’ Leary.“ It’ s an unconscious cycle that can lead to under-vaccinating.”
Some providers simply aren’ t aware of the most effective ways to approach vaccine hesitancy with parents because, up until the last few years, most residency programs weren’ t teaching residents how. Drs. Kempe and O’ Leary are working through community outreach, in-person education sessions and web-based modules to help providers communicate about the topic more effectively.
And many residency curricula now include vaccine hesitancy. Part of Dr. O’ Leary’ s curriculum at the University of Colorado School of Medicine is resident-led.“ I give them the information, and they craft emails for the other residents who are in training,” he says.“ So they all get weekly emails about vaccines written by their peers.”
PINPOINTING THE CAUSE OF HESITANCY
Using the World Health Organization’ s scale, Dr. Kempe and team launched two national surveys over the past year to measure the level of parental hesitancy and pinpoint the cause. The surveys, one for parents of adolescent children and one for younger children, were set up to provide a direct comparison between different types of vaccines.
About 1 in 15 parents qualified as hesitant for routine childhood vaccines. By comparison, almost 1 in 4 parents scored as hesitant for flu and HPV vaccines( 1).
ALLISON KEMPE, MD, MPH
Director, ACCORDS, Anschutz Medical Campus
Ergen Family Endowed Chair in Pediatric Outcomes Research, Children’ s Hospital Colorado
Professor of pediatrics, Division of General Academic Pediatrics, University of Colorado School of Medicine
8 | CHILDREN’ S HOSPITAL COLORADO