Description |
Background: The World Health Organization identifies vaccine hesitancy as a top ten global health threat. Growing hesitancy has decreased childhood immunization rates, significantly threatening public health and increasing the risk of vaccine-preventable disease outbreaks. The COVID-19 pandemic has exacerbated this issue by amplifying distrust in healthcare providers. Local Problem: At a suburban pediatric clinic in Utah, providers lacked standardized approaches and up-to-date tools for addressing vaccine hesitancy. Despite serving a population with increasing rates of vaccine exemptions, providers felt unprepared to effectively communicate with vaccine-hesitant parents. Methods: This quality improvement project utilized the Johns Hopkins Evidence-Based Practice Model. Pre- and post-implementation surveys assessed providers' confidence in addressing vaccine hesitancy. Retrospective chart reviews compared vaccination rates for children aged 0-6 years. Weekly Plan-Do-Study-Act (PDSA) cycles tracked toolkit usage and gathered real-time feedback, enabling refinement. Interventions: Based on evidence-based research, a comprehensive vaccine hesitancy toolkit was developed, incorporating communication strategies and supporting materials. A mixed-media training program, including presentations of key concepts, interactive exercises, and scenario-based practice sessions, was implemented. Six healthcare providers (four Pediatricians, one Family Nurse Practitioner, and one Physician Assistant) participated in the training. Results: Post-intervention, providers reported improvements in communication confidence (33% to 67% feeling "confident") and comfort discussing vaccine risks and benefits (33% to 83%). Implementation assessment demonstrated high acceptability, with 83% of providers agreeing that the toolkit added value. Vaccination rates showed mixed results, with improvements in some age groups (12-month Hepatitis A rates increased by 15% and MMR/Varicella by 23.2%) while others declined significantly (4-6-year-old DTaP/IPV decreased by 62.7% and 4-6-year-old MMRV decreased by 60.3%). Primary barriers were parental vaccine hesitancy, provider time constraints, and ingrained practice habits. Conclusion: This quality improvement project demonstrated the feasibility of implementing an evidence-based vaccine hesitancy toolkit in pediatric primary care. While providers reported increased confidence, the intervention did not consistently increase immunization rates across all age groups, highlighting the need for comprehensive, multi-level approaches to address vaccine hesitancy. |