Provider intervention may not ease maternal caution to vaccines

HealthDay News — A provider-targeted communication intervention does not reduce maternal vaccine hesitancy, and schools with high levels of personal belief exemptions are often colocated with schools with elevated personal medical exemption rates, results of two studies published in Pediatrics indicate.

To examine whether a provider-targeted communications intervention — designed to reduce vaccine hesitancy in mothers of infants and increase provider confidence in discussing vaccines — makes an impact on vaccine adherence, Nora B. Henrikson, PhD, of the Group Health Research Institute in Seattle, and colleagues culled data from a randomized trial of 347 mothers from 56 clinics.

Intervention clinics (n=30) received provider-targeted communications training. Mothers of healthy newborns from these clinics were enrolled at the hospital. Both mothers and providers were surveyed at baseline at 6 months.

Maternal vaccine hesitancy decreased from 9.8% at baseline to 7.5% at follow-up in the provider-targeted communication intervention group, and from 12.6% to 8.0% in the control group. There was no detectable effect for the intervention on maternal vaccine hesitancy (adjusted odds ratio, 1.22; 95% CI: 0.47-2.68).

“Research is needed to identify clinician communication strategies effective at reducing parental vaccine hesitancy in the primary care setting,” concluded the investigators.

In a separate study, Margaret Carrel, PhD, of the University of Iowa in Iowa City, and colleagues, sought to analyze the personal belief exemption (PBE) rates over time, determine the correlates of PBEs, and examine their special overlap with personal medical exemptions (PMEs).

PBE and PME data for California kindergarten classes from 2001/2002 to 2013/2014 school years were matched with locations of schools. When the PBE cluster assignments were mapped, the investigators found distinct spatial patterns in California.

Schools belonging to the “high PBE” cluster were spatially buffered from schools in the “low PBE” and “medium PBE” areas. There was a positive correlation for PBE rates at the percentage of white students, charter status, and private schools.

“Hotspots of high PBE schools are in some cases colocated with schools that have elevated PME rates, prompting concern that herd immunity is diminished for school populations where students have no choice but to remain unvaccinated,” wrote Carrel.