Early childhood vaccinations are important to reduce a possible epidemic of viruses that arise either in a community or a country. The purpose of vaccine uses among those who are pregnant, are parents, and are in an economic disadvantage can greatly decrease the mortality rates of an evolving epidemic. By having healthcare professionals be a part of increasing trust in their community as well as giving accurate information based on scientific-based information on the uptake of vaccines then patients can be more at ease to listen to the doctor’s advice. A community-based intervention will focus on healthcare and pharmaceutical places establishing trust in communities with the addition of other interventions that include educating, advocating, behavior change in people with negative attitudes towards vaccines, and face-to-face interventions. Vaccine uptake has not been a trend despite abundant credible resources explaining the importance of vaccine use for children, adults, and the elderly.
Another component is the community based intervention which will be helpful to make connections with the healthcare sector, government, and local states to makes plans to increase vaccine uptake. The following health communication intervention includes education, spreading the awareness of the importance of vaccine uptake, including primary doctors to increase trust within their community and patients, behavior change strategies, use of new media to increase vaccine rates, and targeting pregnant women on the importance of vaccinating their child. The review will be divided into three parts where the first part will consist of targeting pregnant women on the importance of vaccines. The second part will include community based intervention and how education and advocacy is also essential to spreading the information on vaccine use through various methods followed by behavioral change strategies to increase the efficiency of the target population vaccinating their child. The selection criteria chosen for the selection of references consisted of studies assessing the importance of education of increasing vaccine uptake and journal articles explaining the various methods to increase a positive change to impact the use of vaccines.
The first set of journal articles relate to reviews based on education, behavior changes, and sources of information for vaccine uptake, and the second set of study-based articles pertain to various interventions with pregnant women and the importance of establishing connections with healthcare providers. A study by Brewer NT. Et. al explains that the behaviors of vaccine uptake have to do with how people obtain access through active seeking, where there is a demand, and passive acceptance.2 In high-income countries many vaccines are offered through preventative services, and when children are born as well as in schools as teenagers. In low to middle-income countries there has to be a need for parents to seek out such vaccinations, and education is very important for those in the low to middle-income category. Actively refusing all vaccines is rare, typically around 1% to 2% in high-income countries.2 Radical ant vaccine activists use four tactics. They skew the science, shift their hypotheses, censor dissenting opinions, and attack critics with personal insults and lawsuits.2 Radical ant vaccine activists can increase their advocacy to not choose to vaccinate children, and can result in outbreaks of epidemics. To counteract such activists’ pro-activists for vaccine uptake can be formed to give communities accurate information on the importance of vaccination.
The degree of readiness for a parent to vaccinate their child is at times difficult due to the parents not knowing why vaccination is important, do not understand how, where or when to vaccinate their child, disagree with vaccination as a public health measure, or have concerns about vaccine safety.1 The face-to-face intervention will help achieve positive dialogue between the healthcare professional and the consumer, because consumers can explain their concerns or preferences and ask personally relevant questions.1 Face-to-face intervention will also establish more trust in the patient-physician relationship in order to increase the uptake of vaccine use. There was slight evidence on the effectiveness of education on vaccine uptake and the intention to vaccinate a child.
Danchin M. et al determined that vaccine decision-making starts prenatally10 and educating expectant mothers on the importance of vaccines can increase the efficiency of more coverage area. There were 73% of mothers pregnant with their first child had made a decision regarding vaccination of their unborn child compared to 89% of mothers with children and 6% of first time mothers reported having not heard of vaccinations, compared to 1% of mothers with children.10 First-time mothers should be a priority to education regarding vaccines. Wong VW. Et al has concluded that health care providers should inform all pregnant women on the importance of vaccination, provide positive vaccination recommendations, and use a reminder system.8
Odone A. et al is a journal review that those with text message reminders and the like had increased vaccine rates with being 42% to 73% with standing orders and 15% to 59.7% with physician reminders, so standing order protocols and computerized reminders are effective strategies to increase vaccination rates.6 By incorporating media into the healthcare system there could be more efficiency in people going to their doctor appointments for vaccines. Another Study by Jones, Omer, B.S. et al discusses that internet users were less likely to believe those in government health departments, healthcare providers, and professional organizations.5 The parents who used the internet sought out other information that went against traditional medicine.
Kriss JL, Frew PM, Cortes M, et al. Tdap vaccination in the perinatal period was 18% in the control group, 50% in the IBook group and 29% in the video group.7 Education interventions for pregnant women may be useful to increase Tdap vaccination during the perinatal period.7
Navine, Kozak, Clark C. et al have made a study of exemptions to vaccines, and in Michigan there must be an education source that must be finished in order to be eligible for the exemption of vaccines. Research shows that education requirements can decrease non-medical exemption rates by discouraging some parents from applying for exemptions.9 By discouraging parent from applying for exemptions then vaccine rates increase based on education attained by the parents. In California, a vaccine waiver is granted to those with a religious objection, but it requires people who want personal belief exemptions to meet with a physician to discuss vaccines.3 Families with immunosuppressive children may be more apt to review resources with their child’s physician.3 By having again an effective educational class that parents must take the reduction of cases of those who are not vaccinated goes down. Perkin el al. had a study done on the racial ethnicities for vaccinations of HPV, and the conclusion was that the more education the parents had the more likely they were to vaccinate their child.4 The lack of awareness increased the vaccination shortage of HPV for son’s so increasing education for HPV vaccines would be a benefit for everyone in their community.
Many of the articles and studies are very similar in that education plays a large role in increasing vaccine coverage. There are also behaviors that must be kept in mind when making a strategy plan to efficiency vaccinate a community, and limitations are also discussed of the types of populations that were part of the study. Some of the articles are different, since they describe the various ways to increase vaccination efforts through reminders via text or email and other articles focused more on patient’s source of information, which consisted of internet searches and such self-discovery is not the truth of evidence-based studies.
In the most relevant references radical anti-vaccine activists use tactics to skew the science-based evidence of vaccine use. By doing so, the activists are encouraging people with information that is not accurate and could harm a community. The face-to-face intervention increases the connectedness of patients and physician in order to increase the will to vaccinate. The face-to-face interventions will help achieve positive dialogue between the healthcare professional and the consumer.1 Danchin M. et al determined that vaccine decision-making starts prenatally10 and educating expectant mothers on the importance of vaccines can increase the efficiency of more coverage area. The increase of education also helps immensely to increase the vaccine coverage rates in order to have a community that will have less mortality rates due to not being vaccinated. Some of the flaws for the studies included inadequate populations, since there were not many people included in the studies, then the representative population was not accurate. Another inconsistency is the low amount of studies done on education and vaccine use, so more research must be done in order to effectively show that education greatly improves vaccine rates. The research findings have concluded that education does increases the tendency of parents to vaccinate their child. By having healthcare providers provide knowledge to their patients, then people will be more apt to vaccinate since a trusted relationship with their healthcare provider will be made as well. Advocacy is also key along with a community-based intervention to involve all of those in different sectors to increase the efficiency of vaccines.
1Kaufman J, Ryan R, Walsh L, et al. Face-to-face interventions for informing or educating parents about early childhood vaccination. Cochrane Database of Systematic Reviews. 2018. doi:10.1002/14651858.cd010038.pub3
2Brewer NT, Chapman GB, Rothman AJ, Leask J, Kempe A. Increasing Vaccination: Putting Psychological Science Into Action. Psychological Science in the Public Interest. 2017;18(3):149-207. doi:10.1177/1529100618760521
3Navin M. Prioritizing Religion in Vaccine Exemption Policies*. https://www.bgsu.edu/content/dam/BGSU/college-of-arts-and-sciences/philosophy/documents/conferences/2015 Religious Exemptions/Navin.pdf.
4 Factors Affecting Human Papillomavirus Vaccine Use Among… : The Pediatric Infectious Disease Journal. LWW. https://journals.lww.com/pidj/fulltext/2013/01000/Factors_Affecting_Human_Papillomavirus_Vaccine_Use.20.aspx. Accessed July 14, 2019.
5 Jones, Omer, B. S, et al. Parents’ Source of Vaccine Information and Impact on Vaccine Attitudes, Beliefs, and Nonmedical Exemptions. Advances in Preventive Medicine. https://www.hindawi.com/journals/apm/2012/932741/abs/. Published October 2, 2012. Accessed July 14, 2019.
6 Odone A, Ferrari A, Spagnoli F, et al. Effectiveness of interventions that apply new media to improve vaccine uptake and vaccine coverage. Human Vaccines & Immunotherapeutics. 2014;11(1):72-82. doi:10.4161/hv.34313
7 Kriss JL, Frew PM, Cortes M, et al. Evaluation of two vaccine education interventions to improve pertussis vaccination among pregnant African American women: A randomized controlled trial. Vaccine. 2017;35(11):1551-1558. doi:10.1016/j.vaccine.2017.01.037
8 Wong VW, Lok KY, Tarrant M. Interventions to increase the uptake of seasonal influenza vaccination among pregnant women: A systematic review. Vaccine. 2016;34(1):20-32. doi:10.1016/j.vaccine.2015.11.020
9 Navin MC, Kozak AT, Clark EC. The evolution of immunization waiver education in Michigan: A qualitative study of vaccine educators. Vaccine. 2018;36(13):1751-1756. doi:10.1016/j.vaccine.2018.02.046
10 Danchin M, Costa-Pinto J, Attwell K, et al. Vaccine decision-making begins in pregnancy: Correlation between vaccine concerns, intentions and maternal vaccination with subsequent childhood vaccine uptake. Vaccine. 2018;36(44):6473-6479. doi:10.1016/j.vaccine.2017.08.003