Empowering Youth Vaccine Ambassadors to Promote COVID-19 Vaccination in Local Communities: A 7-Step Approach.

Despite the availability of COVID-19 vaccines for youth since 2021, vaccine hesitancy has resulted in suboptimal uptake. Public health campaigns that empower local youth ambassadors as trusted messengers who share their personal narratives related to getting vaccinated hold promise for promoting COVID-19 vaccination. We used a seven-step approach to develop, implement, and evaluate a youth-led ambassador campaign to promote COVID-19 vaccine uptake in communities experiencing COVID-19 disparities in Worcester, MA. The seven steps included (1) engaging with key partners; (2) determining a community of focus; (3) identifying trusted sources; (4) determining campaign components; (5) training the vaccine ambassadors; (6) disseminating the campaign; and (7) evaluating the campaign. We trained nine youth as vaccine ambassadors. Ambassadors were guided through self-reflection of motivations for COVID-19 vaccination and the resulting personal narratives became the campaign messaging. English/Spanish vaccine messages developed by youth ambassadors were disseminated through social media platforms (n = 3), radio (n = 2), local TV (n = 2), flyers (n = 2,086), posters (n = 386), billboards (n = 10), and local bus ads (n = 40). Qualitative youth feedback indicate participation in the campaign was a positive and empowering experience which reinforces the importance of engaging youth in public health messaging. Youth empowerment through personal narratives (and storytelling) holds promise for future public health campaigns.

Development and Beta-Testing of the CONFIDENCE Intervention to Increase Pediatric COVID-19 Vaccination.

INTRODUCTION: Innovative strategies are needed to improve pediatric COVID-19 vaccination rates. We describe the process for developing a clinic-based intervention, CONFIDENCE, to improve pediatric COVID-19 vaccine uptake and present results of our beta-test for feasibility and acceptability. METHOD: CONFIDENCE included communication training with providers, a poster campaign, and parent-facing educational materials. We assessed feasibility and acceptability through interviews and measured preliminary vaccine intention outcomes with a pre-post parent survey. Interviews were analyzed using rapid qualitative methods. We generated descriptive statistics for variables on the parent survey and used Fisher's exact test to assess pre-post differences. RESULTS: Participating providers (n = 4) reported high levels of feasibility and acceptability. We observed positive trends in parents' (n = 69) reports of discussing vaccination with their provider and the parental decision to accept COVID-19 vaccination. DISCUSSION: Our next steps will be to use more rigorous methods to establish the efficacy and effectiveness of the CONFIDENCE intervention.

Parental perceptions of the COVID-19 vaccine for 5- to 11-year-old children: Focus group findings from Worcester Massachusetts.

Vaccine hesitancy is a long-standing public health issue. The present work describes parental perceptions of COVID-19 vaccination for 5- to 11-year-old children, to aid in vaccination efforts. Parents of 5- to 11-year-old children residing in Worcester, Massachusetts, were recruited through community partner outreach to participate in semi-structured focus groups. Focus groups were conducted via Zoom in English (n = 4) and Spanish (n = 3) with a total of 67 parents. Rapid qualitative analysis was used. Most participants were female and of Hispanic ethnicity. Themes included: (1) Trusted sources and influential types of information (e.g. personal COVID-19 vaccine stories from peers and healthcare providers), (2) Motivations for vaccination: health (i.e. protecting children, families, and communities from COVID-19), (3) Motivations for vaccination: social, emotional, and educational (i.e. mitigating related negative effects of COVID-19), (4) Drivers of vaccine hesitancy (e.g. frustration, uncertainty, and confusion), (5) Differentiating vaccine acceptance, hesitancy, and resistance, (6) Needed information. Although this context may be unique to parents of 5- to 11-year-old children from Central Massachusetts, especially those who may be Spanish-speaking, or of Hispanic ethnicity, this work reinforces the need for effective and persistent communication to combat vaccine hesitancy. In describing parents' perceptions toward COVID-19 vaccination in their 5- to 11-year-old children, we contextualize vaccine hesitancy and highlight opportunities for existing evidence-based communication strategies to increase vaccine confidence and uptake in pediatric populations.

Clinician perspectives on pediatric COVID-19 vaccination: A qualitative study in central and western, Massachusetts.

We explored perspectives of clinicians in central and western Massachusetts about efforts to vaccinate pediatric patients against COVID-19 as well as best practices and challenges for vaccine delivery. We conducted semi-structured qualitative interviews (n = 16) with family practice and pediatric clinicians between late October and early December 2021. Our interviews addressed: process for vaccination and vaccine promotion, parental receptivity to COVID-19 vaccination, receptivity to other pediatric vaccines, resources needed to support vaccine promotion, and best practices developed to encourage hesitant parents. Using a multi-prong recruitment strategy we invited clinicians to participate in telephone interviews, which were audio-recorded and transcribed. We used rapid qualitative analysis to produce summary templates for each interview which were ultimately combined into a matrix summary. The majority of participants (n = 10) were offering the vaccine in their own clinics, while the remainder cited challenges related to staffing, logistics, and space that prevented them from offering the vaccine. Clinicians reported parents fall into three groups: vaccine-accepting, hesitant but potentially accepting, and refusers. Strategies they identified that worked to encourage hesitant parents were sharing personal vaccine stories, acknowledging parents' fears about the vaccine, and being persistent with the most hesitant parents. Yet resources are needed including educational materials and training in how to have these conversations. While challenges related to staffing and space will be difficult to overcome for clinics to be able to offer vaccination on-site, our results highlight the importance of developing effective messaging strategies and training clinicians in how to integrate them into routine practice.