Specialist physician perspectives on clinical decision support to address secondary vaccine hesitancy

Vaccines are an evidence-based intervention that mitigates the impact of infections, yet many Americans indicate hesitancy toward receiving vaccines. One of the most common reasons for this is the potential for experiencing adverse reactions when receiving vaccines. The current literature shows that clinical decision support (CDS) tools have been utilized to improve vaccine coverage.

Our aim was to assess specialist physician experiences, practices, and levels of comfort with evaluating adverse and allergic reactions to vaccines, as well as with addressing secondary vaccine hesitancy, using CDS tools.

Researchers conducted 10 semistructured interviews with physicians in Mass General Brigham's Infectious Diseases and Allergy/Immunology units. The interview guide consisted of 11 questions divided into 4 sections: vaccine conversations, vaccine allergies/reactions, CDS, and structural facilitators/barriers. The interview responses were evaluated by using rapid thematic analysis.

Specialist physicians were generally comfortable talking to patients about vaccine hesitancy but were also open to CDS tools that effectively and efficiently contribute to improved conversations around secondary vaccine hesitancy to increase vaccine uptake. Desired CDS tool features include sharing educational visuals and videos with patients. The risks involve operational delays and lack of real-time data and accountability structures. Clinic modifications such as longer appointment times or group appointments were considered as other ways to help address vaccine hesitancy.

Specialist physicians expressed interest in using CDS tools to improve vaccine-related conversations with their patients. Future CDS tools must account for timely vaccine information and workflow efficiency issues. Future research should include generalist physicians, other health care team members, and patients.