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Published on: August 1, 2019
Peer education as a strategy to promote vaccine acceptance: A randomized controlled trial within New York community
Emily Hoffman1, Tamara Kahan2, Esther Auerbach3
1Department of Medicine, Division of Infectious Diseases at NYU Grossman School of Medicine, 550 First Avenue, New York, NY, 10016, USA.
Insights
Peer-led vaccine education significantly increased pediatric pneumococcal conjugate vaccination acceptance in a randomized trial. This intervention proved most effective for infants under one year old, reducing vaccination delays.
Area of Science:
- Public Health
- Pediatric Medicine
- Health Behavior
Background:
- Strategies to enhance vaccine acceptance are crucial for public health.
- Parental vaccine hesitancy, particularly for pediatric pneumococcal conjugate vaccination, presents a significant challenge.
- Community-based interventions are being explored to improve vaccination rates.
Purpose of the Study:
- To evaluate the effectiveness of a peer-led vaccine education intervention in increasing parental acceptance of pediatric pneumococcal conjugate vaccination.
- To assess if this intervention, delivered within community medical practices, can overcome vaccine deferral.
- To determine the impact of peer counseling on timely infant immunization.
Main Methods:
- A randomized trial was conducted in predominantly Hasidic Jewish neighborhoods in New York from March 2022 to July 2023.
- Parents of children due/overdue for pneumococcal vaccination were randomized to receive routine care or routine care plus peer education.
- Peer educators utilized motivational interviewing and vaccine science to counsel parents; outcomes were assessed at 90 days post-enrollment.
Main Results:
- The peer education group showed significantly higher rates of at least one pneumococcal vaccine dose (28.4%) compared to the control group (12.9%).
- The risk ratio for vaccination in the intervention arm was 2.21 (95% CI: 1.09-4.49, p=0.022).
- The intervention demonstrated a stronger effect in younger children (under 1 year), with 34% receiving vaccination versus 12.7% in the control group (RR 2.67, p=0.009).
Conclusions:
- Peer-led vaccine education is an effective strategy to improve pediatric vaccine acceptance.
- This intervention shows particular promise in reducing vaccination delays among younger infants.
- Community-based peer education can be a valuable tool in public health initiatives to increase immunization coverage.
Background:
Effective strategies are needed to improve vaccine acceptance. This study sought to determine if a peer-led vaccine education intervention embedded within community medical practices increases parental acceptance of pediatric pneumococcal conjugate vaccination.
Methods:
From March 2022-July 2023, we conducted a randomized trial at three pediatric health practices in predominantly Hasidic Jewish neighborhoods in New York, where vaccine deferral is common. Parents of children up to 18 months due/overdue for routine pneumococcal vaccination were randomized (1:1) to receive routine care alone or routine care plus a peer educational intervention. Peer educators trained in motivational interviewing and vaccine science provided counseling at enrollment and follow-up telephone engagement in the intervention arm at day 30 and 60. Primary outcome was child's pneumococcal immunization status by allocation arm expressed as at least one dose received between enrollment and 90 days post-enrollment.
Results:
144 parent-child dyads were eligible for outcome analysis. Participants in the group receiving routine care along with peer-led vaccine counseling were significantly more likely to have their child receive at least 1 vaccine dose between enrollment and 90 days compared to the group who received routine care alone (28.4 % vs 12.9 %, risk ratio [RR] 2.21, confidence interval [CI] 1.09-4.49, p = 0.022). The effect of peer education was greatest in dyads with children less than 1 year old at enrollment (34 % vs 12.7 %, RR 2.67, CI (1.22-5.86), p = 0.009).
Conclusions:
Peer vaccine education can increase vaccine acceptance compared to routine care alone and may be particularly valuable in decreasing vaccination delays for younger infants. (Funded by EGL Charitable Foundation, ClinicalTrials.gov NCT05875779).
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