212 - Messaging Impact on Parental Acceptance of Influenza Immunization in the Emergency Department

Publication Number: 2204.212

Mustafa Mahmood, Albany Medical College, Albany, NY, United States; Yehya M. Maitah, Albany Medical College, Albany, NY, United States; Christopher Woll, Albany Medical Center, Albany, NY, United States

Background:

Background: Under-immunization rates for childhood immunizations is 8-20%. This number continues to grow in recent years as misinformation of vaccine efficacy and safety increases and schools start accepting non-medical exemptions for immunizations. While provider messaging has a significant impact on improving an adult’s willingness to accept influenza immunizations in the emergency department, the impact of provider messaging on a caregiver’s willingness to have their child receive an influenza immunization in the emergency department has not been evaluated.

Objective:

Objective: Describe the impact of provider messaging on a caregiver’s willingness to have their child receive an influenza immunization in the emergency department.

Design/Methods: Methods: This is a 4-pronged nested randomized control trial. Caregivers of patients between 2 months and 18 years old presenting to the emergency department between 11/1/2024 and 2/1/2025 were eligible. Participants were excluded if they were non-English speaking, leveled traumas, critically ill, presenting for possible non-accidental abuse, or no consenting legal guardian present. Caregivers beliefs on childhood immunizations and intent to get their child immunized against influenza this season were assessed. Participants who were initially non-intent, “definitely not immunizing” or “unsure”, were randomized to 1 of 4 immunization messages and then re-assessed for intent. Messages included “Simple opt-in” describing that everyone is offered the immunization, “Community based” describing the benefits to the community in getting their child immunized, “Addressing barriers” describing the resources available to the caregiver to resolve immunization barriers, or “Acknowledgement of hesitancy” describing our understanding of immunization hesitancy while re-affirming our team’s belief that immunizations are safe and effective.

Results:

Results: Forty-one (42.3%) of 97 enrolled participants were initially non-intent on immunizing their child for influenza. The majority of non-intent caregivers cited vaccine efficacy, vaccine safety, child’s low risk of infection, and protection by herd immunity as the reason for their lack of intent. The largest messaging impact was realized with “community based” messaging, with 20% changing from non-intent to intent.

Conclusion(s):

Conclusion: There are widespread concerns relating to immunization efficacy, safety and utility amongst caregivers of children in the United States. There is modest impact of community-oriented immunization messaging in improving caregiver immunization intent in the emergency department.