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Facilitators and Barriers to Providing Vaccinations During Hospital Visits
Mersine A Bryan1,2, Annika M Hofstetter3,2, Daniela Ramos2
1Department of Pediatrics, School of Medicine mersine@uw.edu.
Insights
Many hospitalized children are undervaccinated. This study explored barriers and facilitators to childhood vaccination during hospital stays, finding parents and physicians willing but facing system and communication challenges.
Area of Science:
- Pediatric Health
- Public Health
- Health Services Research
Background:
- A significant number of children are undervaccinated upon hospital admission.
- Understanding factors influencing vaccination during hospitalization is crucial for improving public health outcomes.
Purpose of the Study:
- To explore the facilitators and barriers to administering vaccines to children during their hospital stays.
- To identify key themes influencing hospital-based vaccination from parent and physician perspectives.
Main Methods:
- Qualitative study involving semi-structured interviews with parents of undervaccinated hospitalized children and various physician types (pediatricians, ED physicians, hospitalists).
- Inductive content analysis of transcribed interviews to identify facilitators and barriers.
- Development of a conceptual framework based on the social ecological model.
Main Results:
- Parents and physicians expressed willingness to vaccinate during hospitalization.
- Key facilitators included shared immunization data availability and systemic support.
- Barriers comprised lack of awareness of vaccine eligibility, parental vaccine hesitancy, and healthcare providers' perceived communication skill deficits with hesitant parents.
Conclusions:
- Parents and physicians identified significant facilitators and barriers to hospital-based vaccination.
- Interventions aimed at increasing inpatient vaccination rates must address identified systemic, provider, and parent-level barriers.
Background:
Many children are undervaccinated at the time of hospital admission. Our objective was to explore the facilitators and barriers to vaccinating during hospitalization.
Methods:
We conducted qualitative interviews of parents, primary care pediatricians, emergency department (ED) physicians, and pediatric hospitalists. Parents of undervaccinated hospitalized children who were admitted through the ED were invited to participate. We used purposive sampling to identify physician participants. Semistructured interviews querying participants' perspectives on hospital-based vaccination were audiorecorded and transcribed. Parent demographics and physician practice characteristics were collected. Transcripts were analyzed for facilitators and barriers to vaccinating during acute hospital visits by using inductive content analysis. A conceptual framework was developed on the basis of the social ecological model.
Results:
Twenty-one parent interviews and 10 physician interviews were conducted. Of parent participants, 86% were female; 76% were white. Physician participants included 3 primary care pediatricians, 3 ED physicians, and 4 hospitalists. Facilitators and barriers fell under 4 major themes: (1) systems-level factors, (2) physician-level factors, (3) parent-provider interactional factors, and (4) parent- and child-level factors. Parent participants reported a willingness to receive vaccines during hospitalizations, which aligned with physician participants' experiences. Another key facilitator identified by parent and physician participants was the availability of shared immunization data. Identified by parent and physician participants included the availability of shared immunization data. Barriers included being unaware that the child was vaccine-eligible, parental beliefs against vaccination, and ED and inpatient physicians' perceived lack of skills to effectively communicate with vaccine-hesitant parents.
Conclusions:
Parents and physicians identified several key facilitators and barriers to vaccinating during hospitalization. Efforts to provide inpatient vaccines need to address existing barriers.
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