Promoting Vaccine Confidence in Local Communities through Partnership with Regional Health Offices

vaccination coverage rates and has prioritized its work on strengthening public trust in vaccines. This project aligns with the priority of the OASH to respond to and prevent the coronavirus disease (COVID-19) and other vaccine-preventable diseases, and strategic goals of the HHS including “Goal 2: Protect the health of Americans Where they Live, Learn, Work, and Play” and “Goal 3: Strengthen the Economic and Social Well-being of Americans Across the Lifespan”. Vaccines are among the most effective public health interventions to promote health and prevent diseases. According to the World Health Organization, vaccines prevent between two and three million deaths per year globally. An essential pillar of success for a national vaccine program is maintaining high rates of immunity in communities. To reach the necessary number of vaccinated individuals to achieve community immunity, a high level of public trust in the immunization systems, i.e., vaccine confidence, is needed. In the United States, vaccination coverage for adolescents and adults have generally remained persistently low. Even among children, where coverage rates are high at 90% or higher for most vaccines, nearly 12% of parents refuse at least one recommended vaccine for their children and approximately 30% delay one or more vaccines from being administered to their children. Additionally, non-medical exemptions from school immunization requirements have hindered higher vaccination coverage in children. These data suggest a deficiency in public trust in vaccines. If the national trend of reduced vaccine confidence continues, gains made over the past decades in preventing serious and potentially deadly diseases are threatened. Such erosion may result in more frequent and larger outbreaks of preventable diseases that strain the healthcare system and public health infrastructure and pose an increased threat to national security. Vaccine confidence is defined as having confidence in 1) the safety and efficacy of a vaccine (confidence in the product), 2) the competence of the healthcare professional administering the vaccine (confidence in the provider), and 3) trusting the motivations of the policymakers deciding which vaccines are recommended and when (confidence in the policy). Given the direct relationship between vaccine confidence and vaccine decision making, there is a critical need to understand the determinants of and steps that can be taken to improve vaccine confidence. Efforts to better understand vaccine confidence so that effective interventions can be implemented are ongoing. For example, the National Vaccine Advisory Committee (NVAC), a federal advisory committee of external experts that advises the Assistant Secretary for Health, HHS, is continuing its work to update the report on recommendations regarding determinants of vaccination confidence (Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee. Public Health Rep. 2015 Nov–Dec; 130(6):573–595). NVAC recommended strategies to improve the public’s confidence in vaccines and provided guidance on the use of effective vaccination policies to promote evidence-informed best practices. However, practical solutions to engage healthcare providers, academicians, immunization program managers, vaccine advocates, vaccine manufacturers, and other partners in local communities are needed. This initiative seeks to expand traditional immunization partnerships to plan, implement, and evaluate evidence-based practices and develop novel approaches to increase confidence in vaccines in local communities, particularly partnerships with minority-serving or other advocacy organizations that work with populations with low vaccination rates (e.g., African Americans, Hispanics, and Native Americans; residents in rural communities, medical assistants [when compared to other medical professions]; some immigrant and refugee communities; and young adults [when compared to older adults] and teens and adolescents [when compared to younger children]).