Pediatricians from several AAP chapters took on COVID-19 vaccine hesitancy challenges in Black, Hispanic and rural communities. As a trusted resource, they shared their expertise with schools and public health offices.
Following is an overview of each chapter’s efforts.
Assuaging fears
When the COVID-19 vaccine became available in Washington, D.C., the D.C. Chapter received requests from school officials for information on the science, safety and efficacy of the vaccine. During discussions with educators, staff and parents, chapter members identified a challenge: The schools were in Black and Hispanic communities where historic medical mistreatment instilled mistrust in vaccination efforts.
“Due to our established presence in the community, members of the D.C. Chapter were able to validate these concerns and assuage fears in presentations to groups like parent teacher organizations and school staff meetings,” said chapter Vice President Nia Imani Bodrick, M.D., M.P.H., FAAP. “Because of our diverse membership, we were also able to meet the repeated requests for physicians of color to lead these conversations.”
With positive feedback from stakeholders, the chapter’s school health committee created a school health toolkit (https://aapdc.org/Schooltoolkit/) with COVID-19 resources for mental health among communities of color and children with special health care needs.
Setting up school-based vaccine clinics
The Missouri Chapter also developed a vaccine toolkit for schools (https://bit.ly/3jXmtyg) in partnership with the Missouri Department of Public Health and Senior Services and the Missouri Department of Elementary and Secondary Education. The toolkit provides detailed protocols for setting up school-based vaccination clinics, including a checklist, floor plan, sample email for parents and additional resources. The kit has been distributed to school districts as they ramp up for the new school year.
“We assembled a team of pediatricians from across the state to review the toolkit and provide feedback from their experiences within local communities. School nurses and local public health officials reviewed the toolkit,” chapter Executive Director Kelsey Thompson said.
Developing communication strategy
In Seattle, Douglas John Opel, M.D., M.P.H. FAAP, Washington Chapter quality improvement chair, recognized a lack of vaccine confidence in populations disproportionately affected by COVID-19.
“The chapter developed and published a communication strategy on how clinicians can initiate and discuss COVID-19 vaccines with patients and parents, with particular focus on patients of color,” he said.
A commentary on the strategy was published in the May 2021 issue of the Annals of Internal Medicine (https://doi.org/10.7326/M21-0055). Dr. Opel and co-authors cite the issue of mistrust rooted in past public health experimentation on communities of color as well as structural inequities in government institutions as the reason for mistrust in the COVID-19 vaccine.
“Addressing COVID-19 vaccine mistrust can be a powerful way for any clinician to convey an openness to discussing patient concerns about COVID-19 vaccination and also an interest in patients' lived experiences with structural injustice,” the authors explain. “Initiating these discussions early can start the process of building trust in COVID-19 vaccines among patients of color. Anticipate the possibility of a multivisit process, rather than a single discussion.”
Working with the Washington State Department of Health, the chapter translated the strategy into a flow chart with talking points (https://bit.ly/3AGgfJc) for clinicians to use when discussing COVID-19 vaccination with patients.
“When I use the talking points, I find it facilitates a conversation that parents are really yearning to have. They have a lot of questions and want to be heard,” Dr. Opel said. “They are not always looking to be convinced but often are simply wanting to feel informed and are appreciative of the space to ask their questions.”
Educating school officials
Relationships established between the Montana Chapter and local school districts in the summer of 2020 led to an effort to address vaccine hesitancy in populated and rural areas of the state this year. The Montana Office of Public Instruction and superintendent of public schools asked chapter members to hold sessions with school district superintendents statewide.
“As our members continued to do their work locally, a committee was formed through the chapter to address COVID-19 and child health issues so that these members could coordinate and provide a unified response,” chapter Executive Director Kylee Bodley said.
Committee members met with school boards, school district superintendents, administrators and public health districts using educational materials they developed.
Montana Chapter President John Cole, M.D., FAAP, found that directly addressing parents’ concerns in his practice also helped.
“We have built a trust, so the information coming from me is well-received,” he said. “Most of my patients are getting the COVID-19 vaccine if it is available to them.”
Grant assistance for chapters
The AAP is offering grant opportunities to help chapters boost COVID-19 vaccine confidence and immunization rates through support from the Centers for Disease Control and Prevention.
Nine chapters will receive up to $25,000 to lead the development and implementation of a state strategy and action plan to increase COVID-19 vaccine confidence and uptake in collaboration with state education and public health partners.
Additionally, grants of up to $10,000 are available to all 59 U.S. chapters to work with partner organizations and to customize materials from the AAP COVID-19 vaccine confidence digital toolkit to place social media or digital ads in their communities. For information, email Amanda Wojan at [email protected].
The AAP also is providing free social media training to chapters so they can implement vaccine confidence campaigns and public health initiatives.
