IMC First Section of Final Project

Problem Statement

Vaccine hesitancy among parents is leading to low COVID-19 vaccination rates among daycare-aged children, putting young children and communities at risk of developing significant physical and mental health complications. The unprecedented outbreak of COVID-19 in 2019 and the resulting pandemic from 2020 demanded a fast development and distribution of COVID-19 vaccines. Widespread vaccination is essential to achieving individual and community-level immunity to the pandemic. Different population groups have been disproportionately affected by the outbreak, with varying degrees of risk of infection: IMC First Section of Final Project.

Concerns have existed over the risk of young children getting infected. Emerging COVID-19 variants such as Delta and Omicron have created new concerns over the susceptibility of children to COVID-19. Initial evidence shows that children are at increased risk of infection, especially the unvaccinated (Nathanielsz et al., 2023). Therefore, it is expected that young children at the daycare age to have a higher vaccine uptake rate.

However, the COVID-19 vaccine has been facing significant hesitancy and resistance across the general population at a global level (Lazarus et al., 2022). Vaccine hesitancy, as described by Larson et al. (2022), is the “state of indecision and uncertainty about vaccination before a decision is made to act (or not act).” It, therefore, involves a delay in accepting vaccination or refusal of vaccines despite the availability of the vaccines and safety and efficacy information. The United States is among the countries experiencing the worst vaccine hesitancy among various population groups (Yasmin et al., 2021).

Although a number of studies have indicated an increase in vaccine acceptance ranging between 7.4 to 10.8% between 2020 and 2021, there is still significant evidence supporting the existence of vaccine hesitance in the U.S. (Yasmin et al., 2021). Over 24% of U.S. adults had indicated not to vaccinate their children with the COVID-19 vaccine if it became available. A report by UNICEF (2023) found that 67 million children had failed to receive one or all routine vaccinations between 2019 and 2021. Of these, 48 million had not received a single dose.

The World Health Organization (WHO) also shows a significant drop in confidence in childhood vaccines, with a significant number of children failing to receive any vaccines between 2020 and 2021 (UNICEF, 2023). The lack of confidence in vaccines by parents affects the young children in daycare as they are at a higher environmental risk of exposure.

Potential Effects of Unaddressed COVID-19 Vaccine Hesitancy

The overall utility of the vaccines in controlling the pandemic was and has been associated with its efficacy and safety. However, emerging evidence shows it goes beyond vaccine efficacy and safety to depend on the acceptance of the vaccines among the general public at a global level (Sallam, 2021). The growing vaccine hesitancy and refusal by parents put children at risk of new infections and the overall national and global public health systems. Noting that most cases in children are asymptomatic (Cox, 2023), failure to timely address this growing vaccine hesitancy and refusal means a failure to achieve herd immunity necessary to counter the spread of COVID-19 (Gerretsen et al., 2021).

This leads to a prolonged outbreak of COVID-19 with an associated risk of the emergence of new COVID-19 strains and the outbreak of other diseases, risking higher morbidity (Rawlings et al., 2022). The long-COVID and post-COVID have been linked to the development of clinical systemic conditions, including conditions of the immune, hematological, pulmonary, cardiovascular, skeletomuscular, and nervous systems (Andrade et al., 2021). The health complications of such conditions are expected to be worse for the unvaccinated or those delaying vaccination.

The COVID-19 pandemic has had a significant impact on the global economy; the prolonged outbreak, if not managed through sufficient vaccination, risks health and economic crises (Rawlings et al., 2022). Although the COVID mortality rates among children are low (Nathanielsz et al., 2023), they can become super spreaders and increase COVID-19 infections among adults and related mortality rates.

Causes of COVID-19 Vaccine Hesitancy

Addressing vaccine hesitancy and refusal requires mapping and understanding the various factors contributing to the problem to their degree of influence. It is also necessary to identify the specific factors for vaccine hesitancy within specific populations. Among daycare-aged children, failure to vaccinate is directly and primarily driven by declining confidence in childhood vaccines among parents (UNICEF, 2023).

This is also driven by mistrust in the government and misinformation on the safety of vaccines (Olson et al., 2020). Other major and direct factors of vaccine hesitance include the lack of perceived urgency, peer influence, especially across social media platforms, political ideology, ethnicity, and lack of access to sufficient vaccine safety information (Suran, 2022).

Indirect factors that have contributed to the increased vaccine hesitancy among young children include an inflated belief in children’s immunity and resistance to government vaccine mandates.

Potential Audiences

Primary Audience

The primary audiences for the vaccine uptake promotion program are parents and caregivers of young children in their daycare age. Parents and caregivers are critical decisionmakers in child vaccination matters and usually influence the children’s vaccine uptake behaviors. They are the most affected by vaccine controversies but are most likely to change if provided with the right information on vaccine safety and efficacy.

Secondary Audience

The secondary audience includes teachers, pediatricians, and other healthcare providers. These individuals have broader access to information and can be useful in promoting COVID-19 vaccine acceptance and uptake through educating parents and caregivers and addressing related vaccine concerns.

SWOT Analysis

References

Andrade, B. S., Siqueira, S., De Assis Soares, W. R., De Souza Rangel, F., Santos, N. O., Freitas, A. D. S., Da Silveira, P. R., Tiwari, S., Alzahrani, K. J., Góes-Neto, A., Azevedo, V., Ghosh, P., & Barh, D. (2021). Long-COVID and post-COVID health complications: An up-to-date review on clinical conditions and their possible molecular mechanisms. Viruses, 13(4), 700. https://doi.org/10.3390/v13040700

Cox, D. (2023). What do we know about COVID-19 and children? BMJ, 380. https://doi.org/10.1136/BMJ.P21

Dubé, È., Ward, J. K., Verger, P., & Macdonald, N. E. (2021). Vaccine Hesitancy, Acceptance, and Anti-Vaccination: Trends and Future Prospects for Public Health. Annu. Rev. Public Health, 42, 175–191. https://doi.org/10.1146/annurev-publhealth

Gerretsen, P., Kim, J., Caravaggio, F., Quilty, L., Sanches, M., Wells, S., Brown, E. E., Agic, B., Pollock, B. G., & Graff-Guerrero, A. (2021). Individual determinants of COVID-19 vaccine hesitancy. PLOS ONE, 16(11), e0258462. https://doi.org/10.1371/JOURNAL.PONE.0258462

Khuntia, J., Ning, X., & Stacey, R. (2022). Competition and Integration of US Health Systems in the Post-COVID-19 New Normal: Cross-sectional Survey. JMIR Formative Research, 6(3), e32477. https://doi.org/10.2196/32477

Larson, H. J., Gakidou, E., & Murray, C. J. L. (2022). The Vaccine-Hesitant Moment. New England Journal of Medicine, 387(1), 58–65. https://doi.org/10.1056/NEJMRA2106441/SUPPL_FILE/NEJMRA2106441_DISCLOSURES.PDF

Lazarus, J. V., Wyka, K., White, T. M., Picchio, C. A., Rabin, K., Ratzan, S. C., Parsons Leigh, J., Hu, J., & El-Mohandes, A. (2022). Revisiting COVID-19 vaccine hesitancy around the world using data from 23 countries in 2021. Nature Communications, 13(1), 1–14. https://doi.org/10.1038/s41467-022-31441-x

Nathanielsz, J., Toh, Z. Q., Do, L. A. H., Mulholland, K., & Licciardi, P. V. (2023). SARS-CoV-2 infection in children and implications for vaccination. Pediatric Research, 93(5), 1177–1187. https://doi.org/10.1038/S41390-022-02254-X

Olson, O., Berry, C., & Kumar, N. (2020). Addressing parental vaccine hesitancy towards childhood vaccines in the United States: A systematic literature review of communication interventions and strategies. Vaccines, 8(4), 590. https://doi.org/10.3390/VACCINES8040590

Rawlings, L., Looi, J. C. L., & Robson, S. J. (2022). Economic considerations in COVID-19 vaccine hesitancy and refusal: A survey of the literature*. Economic Record, 98(321), 214–229. https://doi.org/10.1111/1475-4932.12667

Sallam, M. (2021). COVID-19 vaccine hesitancy worldwide: A concise systematic review of vaccine acceptance rates. Vaccines, 9(2), 1–15. https://doi.org/10.3390/VACCINES9020160

Suran, M. (2022). Why parents still hesitate to vaccinate their children against COVID-19. JAMA, 327(1), 23–25. https://doi.org/10.1001/JAMA.2021.21625

UNICEF. (2023, April 20). New data indicates declining confidence in childhood vaccines of up to 44 percentage points in some countries during the COVID-19 pandemic. https://www.unicef.org/rosa/press-releases/new-data-indicates-declining-confidence-childhood-vaccines-44-percentage-points-some

Van Scoy, L. J., Snyder, B., Miller, E. L., Toyobo, O., Grewel, A., Ha, G., Gillespie, S., Patel, M., Reilly, J., Zgierska, A. E., & Lennon, R. P. (2021). Public anxiety and distrust due to perceived politicization and media sensationalism during early COVID-19 media messaging. Journal of Communication in Healthcare, 14(3), 193–205. https://doi.org/10.1080/17538068.2021.1953934

Yasmin, F., Najeeb, H., Moeed, A., Naeem, U., Asghar, M. S., Chughtai, N. U., Yousaf, Z., Seboka, B. T., Ullah, I., Lin, C. Y., & Pakpour, A. H. (2021). COVID-19 Vaccine hesitancy in the United States: A systematic review. Frontiers in Public Health, 9, 770985. https://doi.org/10.3389/FPUBH.2021.770985/

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Week 1/Section 1. Problem Description Write a problem statement. Due on Mon. 1/27 at 11:59 p.m.
The health problem is the gap between an acceptable or desirable health status and the current status. For the below, be sure to cite your sources. This assignment should be research-based, rather than opinion-based.To write your problem statement, answer these questions:

• What should be occurring? What is occurring?
• Who is affected and to what degree?
• What could happen if the problem isn’t addressed?

Use health status indicators to answer the first 3 questions. Health status indicators are data on outcomes or their causes (e.g., smoking rates). Health status indicator data is made available by numerous organizations.

There are numerous organizations that provide health status indicators. Here are some sources you can consider:

• New York Times Mississippi Vaccine Mandates – PDF on BB
• COVID-19 specific information in Mississippi: https://msdh.ms.gov/page/resources/13827.pdf
• Status of childhood vaccines in the U.S.: https://www.pewresearch.org/science/2023/05/16/americans-largely-positive-views-of-childhood-vaccines-hold-steady/
• Brief Review Article about Parental Vaccine Hesitancy in Readings folder on Blackboard
• UNICEF report: https://www.unicef.org/rosa/press-releases/new-data-indicates-declining-confidence-childhood-vaccines-44-percentage-points-some

Please note that the link provided in the PDF is broken, so you can use the links mentioned above instead.

2. List and map the causes of the health problem (vaccine hesitancy/vaccine refusal/lack of vaccine uptake).
Consider the following:

• genetic or biological factors
• psychological factors
• behaviors
• factors in the physical environment (e.g., a lack of transportation)
• factors in the social environment (e.g., social support, or policy)

Categorize the causes as direct and indirect, and as risk and protective factors. Weigh the factors and determine which ones are the primary factors.

Determine which of these can change as a result of programmatic action? (e.g., a social marketing program can’t eliminate genetic risk factors).

IMC First Section of Final Project

3. Identify potential audiences.
Grouping the audience into meaningful segments will allow you to design efficient and effective strategies for reaching them.