Advances and Answers in Pediatric Health
For influenza vaccine , the hesitancy was about effectiveness . Parents don ’ t believe it works . “ You can understand how that ’ s happened ,” says Dr . Kempe . “ Every year there ’ s all these discussions about , ‘ Is there a good match with the flu vaccine ?’” Even with a low match , of course , a flu vaccine decreases severe disease and hospitalization . But that doesn ’ t seem to be sticking with parents , she says .
With the HPV vaccine , it ’ s the conversations about sexual activity that make parents uncomfortable . That finding actually led to a currently active randomized controlled trial looking at whether introducing the HPV vaccine earlier , at say 9 or 10 years old , is better for uptake than the routine age of 11 or 12 .
“ By introducing the vaccine earlier , which is safe and currently within the recommendation guidelines , maybe we can separate discussion about the vaccine with discussions about sexual activity .” says Dr . Kempe , “ Instead , we can really focus on the cancer prevention aspect similar to the way we approach the hepatitis B vaccine with parents and their babies .”
ADDRESSING SKEPTICISM
“ One thing medical experts have been pondering during the COVID-19 pandemic is : Will it lead to a reversal of this decades long assault on science ?” asks Dr . O ’ Leary . “ I ’ m part of a study right now where we ’ re enrolling parents of newborns and measuring their hesitancy over time .”
The study , which finishes enrolling in July , will follow the participants ’ vaccination uptake for 18 months past initial enrollment . “ I would love to think that hesitancy will decrease , given everything we ’ ve gone through over the past year , but we ’ ll see ,” he says .
Drs . Kempe and O ’ Leary hope their research will eventually help them put a prebunking initiative into place , essentially getting information to individuals before they develop hesitancy views .
“ We don ’ t know as much as we need to , particularly at the population level , to know how to approach this yet ,” says Dr . Kempe . “ But we do know we should be using parents who are pro-vaccination as advocates to help normalize vaccination , we need to do more in the prenatal period before parents hear misinformation about childhood vaccines , and we need to be using social media more effectively .”
Dr . Kempe is the founding director of the Adult and Child Consortium for Health Outcomes Research and Delivery Science ( ACCORDS ), a program funded in part by Children ’ s Colorado to support innovative and interdisciplinary research across the Anschutz Medical Campus . It ’ s the only program of its kind in the country , and it ’ s well known for its work on immunization delivery . Increasing vaccine delivery is especially important in communities of color , who are historically skeptical of the medical field and are disproportionately affected by both access issues and disparities .
“ ACCORDS has fellowships where we train fellows and faculty in health services research to be able to answer concrete questions like how to get immunizations delivered to those who need them most ,” says Dr . Kempe . “ And together with community organizations like Immunize Colorado , which has put together a COVID-19 taskforce to deliver targeted messages via trusted messengers within specific communities , we ’ re hoping we can make a significant impact .” •
1 . Kempe A , et . al . Parental Hesitancy About Routine Childhood and Influenza Vaccinations : A National Survey . Pediatrics , U . S . National Library of Medicine , Vol . 147 , Issue 3 , 1 Mar 2021 .
SEAN O ’ LEARY , MD , MPH
ACCORDS investigator
Director , Colorado Pediatric Practice-Based Research Network ( PBRN )
Professor of pediatrics , Sections of Pediatric Infectious Diseases and General Academic Pediatrics , University of Colorado School of Medicine
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