Physician-targeted intervention failed to reduce maternal vaccine hesitancy

A Washington state physician-targeted communication intervention did not reduce maternal vaccine hesitancy or improve physician self-efficacy, according to new study findings.

It is known that physicians have a significant influence on parental vaccination decisions. For this reason, Nora B. Henrikson, PhD, of Group Health Research Institute in Seattle, and colleagues sought to assess the impact of a physician-targeted communication intervention designed to reduce vaccine hesitancy in mothers of infants and to increase physician confidence in communicating about vaccines.

The intervention consisted of a one-time 45-minute training session and a 6-month follow-up communication period for physicians, encouraging them to use respectful, open dialogue with parents while recommending vaccination.    

The community-based, clinic-level, two-arm cluster randomized trial included 56 clinics across Washington and 347 mothers of healthy newborns. The researchers surveyed both mothers and physicians at baseline and again at 6 months. The primary outcome measure was maternal vaccine hesitancy, while the secondary outcome was physician self-efficacy in communicating with parents.

Variables were similar for both arms, except maternal race and ethnicity. The overall mean maternal age was 32.2 years, 90% were married or partnered and 73% were college graduates or higher. Forty-six percent resided in a household with income of $100,000. When compared with controls, the intervention arm was more likely to be white (84% vs. 69%; P = .01) and 46% were first-time parents.

Intervention trainings were conducted across 30 clinics, reaching 67% of eligible physicians. Twenty-six clinics were randomly assigned to the control arm, meaning they received no intervention.

There were fewer physicians included in the intervention arm who reported high confidence when discussing vaccination risks (58% vs. 70%; P = .06), providing information (69% vs. 81%; P = .03) and answering difficult questions from parents (54% vs. 69%; P = .01).

Compared with a 9.8% maternal vaccine hesitancy at baseline for the intervention arm, vaccine hesitancy only slightly decreased to 7.5% at 6-month follow-up. For controls, maternal vaccine hesitancy at baseline was 12.6% and decreased to 8% at follow-up.

Maternal vaccine hesitancy was not affected by the intervention (adjusted OR = 1.22; 95% CI, 0.47–2.68), according to the researchers.  

“Further research should determine the most effective approaches to addressing vaccine hesitancy,” Henrikson and colleagues wrote. “Also, more foundational and conceptual work is needed on the optimal approaches to communicating with vaccine-hesitant parents, and delivering feasible, high-dose communication interventions with physicians where the ultimate target is parent behavior.”

Disclosure: The researchers report no relevant financial disclosures.