Vaccine attitudes, practices, and literacy among New York State primary care providers and their office personnel

Abstract

Consistency of the healthcare delivery team's communication to families is influential in vaccine decision-making. We aim to describe personal vaccine practices, attitudes, and literacy among New York State primary care office providers and personnel. We disseminated an anonymous survey to providers and office personnel (including but not limited to front office staff, medical assistance, nurses, advanced practice providers, and physicians) of 12 primary care practices between May and July 2023. Responses were assessed using chi-square tests, t-tests, and one way ANOVA tests to compare categorical variables, the means between two groups, and means across multiple groups, respectively. 216 respondents completed the survey. 25/213 (12%) and 16/147 (11%) reported declining routinely recommended vaccine(s) for themselves or for their child(ren), respectively, most commonly the COVID-19 and/or influenza vaccines. Less than three-quarters of respondents strongly agreed with the following statements: vaccines are safe to administer to children (149/214, 70%), vaccines are safe to administer to adolescents (149/213, 70%), and vaccines are effective in preventing disease (146/213, 69%). In total, 149/213 (70%) and 89/211 (42%) of respondents report that parents express concerns to them about vaccines in the clinic and outside of the practice setting, respectively, yet just over half of the respondents (116/210, 55%) report strong agreement with being comfortable having vaccine conversations with parents. Vaccine hesitancy exists across all healthcare team roles. Practice-wide education regarding vaccine safety, efficacy and importance and strategies for communicating about vaccines with patients and families is needed to improve vaccine confidence among the healthcare teams and patients.

Keywords: Vaccine confidence; immunization; vaccine acceptance; vaccine communications; vaccine hesitancy; vaccine literacy.

Figure 1.

Factors associated with strong agreement with statements assessing vaccine attitudes stratified by practice role (a), race (b), and highest level of education (c) among participating New York State pediatric practice providers and staff. (a) *p < .001, **p.03 Chi-square testing was performed to determine p-value comparing proportion reporting strong agreement among participants in each category. (b) *p < .001 Chi-square testing was performed to determine p-value comparing proportion reporting strong agreement among participants in each category. (c) *p < .001 Chi-square testing was performed to determine p-value comparing proportion reporting strong agreement among participants in each category.

Figure 2.

Factors associated with strong agreement with being comfortable with having conversations about vaccines with parents stratified by provider role, time in provider role, race, and highest level of education. *p < .001, **p < .01 Chi-square testing was performed to determine p-value comparing proportion reporting strong agreement among participants in each category.

Figure 3.

Factors associated with parents reporting of vaccine concerns to participating New York State pediatric providers and staff in the clinic (a) and outside of the practice setting (b). (a) *p < .001 Chi-square testing was performed to compare proportions among each group. (b) *p < .001 Chi-square testing was performed to compare proportions among each group.

Figure 4.

Sources of vaccine information as reported by the respondents’ practice role. *p < .05 using chi-square testing to compare responses by provider role.

Figure 5.

Aggregate functional (a) and integrative/critical (b) vaccine literacy responses by participating New York State pediatric practice providers and staff.