ARISe Coordinating and Collaborating Centers for the Study of Vaccine Hesitancy and Uptake (CDC SIP 12)

New York University School Of Medicine, New York NY

Investigators

Abstract

Building on a robust, multi-sector partnership between the City University of New York (CUNY) School of Public Health, the NYU Grossman School of Medicine’s Department of Population Health, the proposed project aims to increase scholarly understanding of vaccine hesitancy and provide federally-qualified health centers with managerial and ethical guidance on how increase routine vaccine uptake among children 0-2yrs. Over the five year project period, NYUGSoM will lead on two research projects: one, a mixed-methods exploration of vaccine attitudes and beliefs among parents 0-2 years and a second, a managerial and ethical analysis of an evidence based practice for increasing pediatrics vaccination at a federally qualified health center. Throughout the project period, CUNY will lead activities to coordinate between the funded Collaborating sites and disseminate past and new findings through a robust partner network. The first piece of research gathers individual-level data about the roots of vaccine hesitancy and skepticism among parents of young children, and critically, how these attitudes have been overcome by individuals who subsequently vaccinated 0-2yr old children. We will design and field an online survey of parents of 0-2 years, recruiting participants via social media. The survey will be designed to assess the quality of parents’ relationship to health care providers and test the acceptability of various behavioral economics approaches to increasing vaccine uptake. The survey will also act as a recruitment device for follow-up interviews among select participants who report having once been vaccine hesitant or skeptical but now have children who are up to date on all vaccines. These interviews will generate data for analysis on how vaccine hesitancy and skepticism has been overcome. The second piece of research focuses on organizational-level efforts to increase vaccine uptake among 0-2 year olds, specifically in a federally qualified health center. Informed by behavioral economics and prior literature indicating effectiveness, a local FQHC adopted an “opt-out” approach to pediatric vaccination where parents are assumed to consent to vaccination unless they specifically object. Guided by implementation science frameworks, we will collect data on-site about how this “opt-out” approach is managed to create clear guidance for other FQHCs nationally that may want to adopt, or adapt a similar approach. Informed by staff perspectives as well as the previously mentioned parent survey, we will also generate a set of ethical considerations for using an “opt-out” approach to vaccination in an FQHC population which is often facing various sources of marginalization and disempowerment. The proposed project is closely aligned with at least four Healthy People 2020 Objectives: (1) to maintain the elimination of measles, rubella, congenital rubella syndrome and polio, (2) reduce proportion of children who get no recommended vaccinations by 2 yrs of age, (3) maintain the vaccination coverage level of 1 dose of the MMR vaccine in children by 2 years and (4) increase the coverage level of 4 doses of DTaP vaccine by 2 yrs of age.