GCH Pediatric Practice provides a model for addressing vaccine hesitancy and barriers

Reviewed by Emily Henderson, B.Sc.Nov 7 2021

Golisano Children's Hospital (GCH) Pediatric Practice in Rochester, NY demonstrated success in vaccinating eligible patients as well as their caregivers by offering the vaccine to both during pediatric visits, and provides a model for addressing vaccine hesitancy and barriers, according to an October 8^th article published in JAMA Pediatrics' Viewpoint.

The article, "COVID-19 Vaccination for Caregivers in the Pediatric Medical Home: A Call to Action to Improve Community Vaccination Rates," outlines how pediatric practices are well-positioned to improve community vaccination rates by vaccinating caregivers along with their own patients in the pediatric medical home – a convenient place where the input of trusted physicians can help address vaccine hesitancy.

"Pediatricians talk about vaccines with patients and families daily and have substantial experience discussing vaccine hesitancy and concerns. Parents rely on their pediatric clinician for vaccine information most often, and a physician's recommendation is associated with higher rates of uptake for specific vaccines," wrote the study's co-authors, Andrea Milne Wenderlich, M.D., Cynthia Rand, M.D., M.P.H., and Jill Halterman, M.D., M.P.H., GCH faculty who serve in the Division of General Pediatrics and as Pediatricians in the Golisano Children's Hospital Pediatric Practice.

The Golisano Children's Hospital Pediatric Practice serves more than 13,000 patients, most of whom are children from minority communities who reside in high poverty areas of Rochester. The paper outlines several potential barriers to COVID-19 vaccination including:

• Difficulties with transportation/taking off time from work,
• Hesitancy related to long-standing mistrust from historically racist medical and research practices, and
• Concern about potential vaccine side effects

To address these concerns, the GCH Pediatric Practice secured the resources to vaccinate pediatric patients as well as their caregivers during regular office visits as well as at several after-hours back-to-school clinics in August and September. To implement this plan, the clinic arranged additional staffing with support from Strong Memorial Hospital, secured adequate vaccine supplies, and encouraged all team members who interact with patients and families in the practice (eg, physicians, nurse practitioners, nurses, social workers, behavioral health specialists) to ask about the COVID-19 vaccine, offer the opportunity for discussion with a clinician, and inform them of the opportunity to receive the vaccine in the office if desired.

The practice found multiple positive outcomes with this approach, according to the article. Caregivers reported appreciation for the convenience afforded by getting the vaccine while they were already at a visit for their child, and several stated that they felt greater comfort and trust getting the vaccine in the pediatric practice. Many caregivers chose to get the vaccine in solidarity with their child who was also eligible to be vaccinated. Overall, more than 60 caregivers were vaccinated in the first month that the vaccine was offered, with more than 1,400 COVID-19 vaccine doses given to date.

This initiative showed that hesitancy can be addressed by providing a comfortable and accessible setting for caregivers to discuss the vaccine with a trusted provider."

Jill Halterman, M.D., M.P.H., Division Director of General Pediatrics

"Many parents were grateful for the opportunity to be vaccinated with their children, stating how they just felt more comfortable getting the vaccine here because they've been coming for years and have a trusting relationship with us.", said Heather Wensley, NP, nurse manager of the practice and Manager of Advanced Practice Providers for GCH.

The success of this program indicates that pediatricians could effectively address concerns in vaccine-hesitant communities, and it could serve as model for other pediatric practices throughout the country.

"With the Delta variant of the virus still active in our community, it is critical to get as many eligible children and caregivers vaccinated to limit opportunities for infection spread and further disruption to in-person school," said Halterman, "pediatric clinics have an important opportunity to contribute to this effort."