Vaccine Hesitancy Simulation Training

Why is this Program Important?

Vaccine hesitancy is a global priority with many global partners working toward a solution. Vaccines have the power to prevent 2 – 3 million deaths every year, making them one of the most cost-effective public health interventions crucial to achieving optimal health, education, and economic development as set out in the Sustainable Development Goals (SDGs). Yet, many caregivers are choosing not to have their children vaccinated, and research shows that poor provider-patient interactions are one of the leading causes of vaccine refusal.

According to the World Health Organization Strategic Advisory Group of Experts (SAGE) Vaccine Hesitancy Working Group report released in 2014, vaccine hesitancy is context specific and requires attention and research from low-, middle-, and high-in-come countries to assess and determine best practices. The report also highlighted social marketing driven approaches, such as motivational interviewing to determine root causes of hesitancy, as one of the most promising practices.  Since 2014, WHO Europe, the Centers for Disease Control and Prevention's Global Demand Creation Team, and UNICEF have all been working to better define vaccine hesitancy and develop complementary tools and resources that can be adapted in a variety of settings. However, robust effectiveness data highlighting successes and weaknesses across multiple geographies and income levels are lacking. We do know that higher parental education and knowledge as well as access to health information are associated with vaccine hesitancy in higher-income countries, while these same factors are associated with vaccine confidence in low- and middle-income countries.

Current strategies to address vaccine hesitancy at the provider level have predominantly engaged public sector health work-ers (e.g. WHO's Global Mid-Level Management Modules and Immunization in Practice- A practical Guide for Health Staff) using traditional training approaches such as didactic, lengthy in-person trainings. As such, many countries with an active private sector are seeing increased disparity in immunization services across sectors, as well as impacts of mixed messaging and siloed engagement from global partners, governments, and the scientific medical community that leave the private sector without the support it needs to combat hesitancy. 

Who Can Benefit?

The end-user of this training is any vaccinator. Depending on the country this could be: pediatrician, nurse/midwife, general practitioner, family physician. Ministries of Health, private sector monitoring/licensing bodies, hospital, clinic networks, medical schools & training institutions all may be groups interested in implementing.

The curriculum will be a suite of resources that guide groups on how to adapt the curriculum for their context, including associated simulation aspects. Therefore, this curriculum could be implemented in any market (domestic and international).

Program Details

Using global evidence and expertise of American Academy of Pediatrics (AAP) members, the Vaccine Hesitancy Simulation curriculum will support immunizers to identify socio-cultural causes of vaccine hesitancy in their context and build their skills in addressing them through a simulated patient experience.

This solution as implemented includes a capacity building component where AAP provides capacity building support to the national pediatric association to build a local cohort of trainers that can support on-going learning and adaptation of drivers of vaccine hesitancy. It could be marketed with the capacity build-ing component as an option to implementing the training.

How is the Program Implemented?

The training itself is meant for an in-person format. It is a 6 – 8 hour training. AAP can provide in-person facilitation of the training.

Delivering Value and Impact

We have not implemented this training yet so do not have specific outcomes data. However, we anticipate that it will improve uptake of immunizations as well as understanding of behavioral drivers of vaccination uptake that vaccinators can impact. 

Vaccine hesitancy is a global problem, that will likely worsen with the introduction of the COVID-19 vaccine.