With a coronavirus vaccine on the horizon, there is increasingly more content in the mainstream media about whether individuals will want to get this new vaccine. How do you convince someone that vaccines are the best way to protect children and ourselves from life-threatening infectious diseases? In-person conversations are clearly helpful. To test another approach, Glanz et al (10.1542/peds.2020-0669) share with us the results of the web-based intervention project called “Vaccines and Your Baby” (VAYB) which provided online messages tailored to vaccine beliefs of new parents four times between pregnancy and when a child turned 15 months of age. The study authors conducted a randomized controlled trial comparing VAYB with an untailored web-based intervention (UT) and with usual pediatric care. The primary outcome was whether children were up to date with their vaccines. The hope was that this would sway parents who were vaccine hesitant and had messages tailored to their hesitancy choice to vaccinate more than the other two groups. Unfortunately, the VAYB intervention did not do that. In fact, fewer vaccine hesitant parents (though they were small in number) opted to vaccinate when compared to the UT group, and there were no differences in up to date vaccination rates across any of the groups when compared with each other.
Does this negative study of the VAYB strategy suggest an online texting approach should not be tried? Not necessarily—according to an accompanying commentary from bioethicist Dr. Douglas Opel and vaccination expert Dr. Edward Marcuse (10.1542/peds.2020-013342), both at Seattle Children’s Hospital. Drs. Opel and Marcuse point out a number of limitations of this study that could have resulted in the negative results and offer a number of additional suggestions as to what contributed to the disappointing results, and what future studies looking at online interventions would need to do going forward if they want to show the effectiveness of such an approach. A key take-home point from the commentary is to start educating about the value of vaccinating infants and children even before pregnancy. The need to understand vaccine attitudes that shape behaviors to have a child vaccinated has never been more important as we might have a new vaccine that could potentially end the pandemic—but only if people opt to take advantage of it. This study and commentary will help reshape strategies to better understand how to change vaccine hesitant behaviors for the better.
