A randomized trial to increase acceptance of childhood vaccines by vaccine-hesitant parents

Increasing numbers of parents delay or refuse one or more of the recommended childhood vaccines. Strategies are needed to provide accurate and effective information to counter this trend. To perform a cluster randomized trial of an educational intervention for vaccine-hesitant parents in the outpatient clinic setting. Two primary care sites were randomized to provide families with either usual care or a brief video-based educational intervention addressing common concerns of vaccine-hesitant parents. Parents were approached at their child's 2 week well visit and eligible if performance on the Parent Attitudes about Childhood Vaccines (PACV) survey suggested vaccine-hesitancy (score ≥ 25). At 2 months, PACV surveys were completed again and vaccination status was collected at 12 weeks. The difference in PACV scores at screening and 2 months, and the proportion of on-time vaccination, was compared between groups. Four hundred and fifty-four parents were approached and 369 (81.3%) consented to screening; 132 had PACV scores ≥ 25 and were randomized (67 in the control group [mean PACV score 36.6] and 55 in the intervention group [mean PACV score 40]). The intervention group had a significant decrease in PACV score at two months compared to the control group (median difference= - 6.7, p=.049). This finding remained significant after adjustment for baseline PACV score, race/ethnicity, and income (p=.044). We found no difference in the on-time receipt of vaccines at 12 weeks. An intervention to improve parental attitudes regarding childhood vaccines for vaccine-hesitant parents was associated with a modest but significant increase in measured vaccine acceptance.