Background: Understanding public knowledge and questions about vaccination is essential for health communication.

Methods: We surveyed 470 adults in four states (MO, NE, NC, GA) from March 15-17, 2025 asking, “Have you heard anything about vaccines in the last 2 weeks?"; and “Do you have any questions about vaccines?” Those answering “yes” to either question were asked to share what they heard and what questions they had (open-ended). The survey, part of a longitudinal community health knowledge project, was administered during the Texas measles outbreak and after the FDA flu vaccine advisory meeting cancellation.

Results: Among 377 respondents (80% response), 50.4% heard something about vaccines and 14.3% had questions. Hearing about vaccines varied significantly by race/ethnicity, with Non-Hispanic White respondents most frequently having heard something about vaccines (62.5%). Those with minor children in their household were more likely than others to have questions (19.2% vs 11.7%). Qualitative analyses revealed that what people heard about vaccines focused on political figures, policy, safety, effectiveness, and necessity. Hearing about policies and political figures in relation to vaccines varied by state, having minor children, and race/ethnicity. Those from Nebraska, those with minor children, and Non-Hispanic White respondents heard about policies and political figures most. Frequent question topics included whether vaccines are safe, effective, and necessary.

Conclusions: Although half of adults surveyed reported hearing information about vaccines, both exposure to information and what they heard varied by sub-group. Having questions about vaccines was less common, though some nuanced questions were identified that merit thoughtful responses.

Background: Despite evidence showing that starting HPV vaccination at age 9 results, national and professional guidelines differ in the strength of their recommendations to start HPV vaccinations at age 9. UT Physicians leveraged various EHR tools to support and educate clinicians in starting HPV vaccinations at age 9.

Methods: We leveraged our EHR’s population health tool to create a health maintenance topic for HPV (Vaccine) Age 9, that included a provider reminder and recall (R&R) at the point of care and an immunization forecaster tool. The HPV Age 9 care gap displays in the patient’s chart and can be easily addressed with one click. We also created a custom provider audit and feedback (A&F) tool to show completion rates at provider, department, and system level with customizable look back periods and eligible patient lists. We provided role-based training to primary care clinics and met with clinics monthly to review the A&F dashboard. We also built an immunization order set that providers can use to easily order HPV vaccinations for patients 9-18.

Results: We provided role-based training to 101 providers and staff. Using the R&R and A&F tools, we identified that 79,999 patients aged 9 are eligible for vaccination. Preliminary results show that 1,686 patients HPV Age 9 vaccination status showed as complete in March 2025.

Conclusion: Our early findings indicate that pairing evidence-based EHR tools and strategies with role-based training can improve HPV vaccination initiation at age 9 and increase vaccination completion rates.

Introduction: Misinformation about the HPV vaccine on social media contributes to vaccination concerns. Misinformation is difficult to correct, but "pre-bunking" strategies can confer resistance to misinformation before it is viewed mitigating the harmful effects. These studies sought to determine the effects of pro-HPV-vaccine arguments on combatting concerning misinformation about the HPV vaccine and to evaluate the strongest pre-bunking messages in an RCT.

Methods. In May 2023, 523 caregivers of children ages 8-12 who had not received the HPV vaccine completed an online survey. Participants viewed a control message or a mini-message campaign of 6 pro-vaccine arguments randomly selected from a pool of 59 arguments. Participants rated message strength and indicated their intentions to vaccinate their child. Participants then viewed 5 concerning misinformation tweets and rated whether the tweet provided a believable reason to avoid getting the HPV vaccine. We analyzed the data using linear and logistic regression. The strongest messages were used to create pre-bunking stimuli to compare to a control message.

Results: Stronger campaigns increased intentions to get their child the HPV vaccine (β=.88) and lowered the odds of being susceptible to HPV misinformation (OR=.26). Baseline data is being collected in a follow-up RCT with a wave 2 survey scheduled in June. These data will assess the effects of pre-bunking on HPV vaccination initiation in the field.

Conclusion: Viewing strong pro-HPV vaccine messages had a protective effect against believing common concerning HPV misinformation. Preliminary RCT results can show the extent that this protective effect impacts vaccination behavior.

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection among ages 15-24 years. However, many individuals remain unvaccinated against HPV. Recommendations from friends and family have been shown to improve vaccine uptake. Our goal was to determine if, and among whom, the likelihood of recommending the HPV vaccine positively changed following the provision of vaccine-related information.

Methods: We recruited participants at two no-cost vaccine clinics in September and October 2024 (N = 556; age range = 18 – 75 years, 59.5% female). Through a one-time, voluntary online survey, we asked participants how likely, on a scale of 1(very unlikely) to 5(very likely), they were to recommend the HPV vaccine to a family or friend. We repeated this question after sharing a list of HPV vaccine-preventable diseases. Analyses included a dependent t-test to examine the change in mean pre and post-recommendation scores and multivariable logistic regression) analyses to examine factors associated with a positive change versus no/negative change. All analyses were conducted using IBM SPSS Statistics (Version 29).

Results: The average post (Mean = 4.21; SD = 0.95) recommendation score was higher than the pre (Mean = 3.87; SD = 1.03) recommendation score (t = 11.37; p < 0.001). A positive change was associated with younger age (aOR = 0.98, p = .02) and lower vaccine confidence (aOR = 0.50, p < .001).

Conclusion: Future education interventions should target younger individuals and those with lower vaccine confidence to improve the likelihood of recommending the HPV vaccine.

Background: Deaf individuals have lower COVID-19 vaccination rates and face a higher risk of severe health outcomes compared to the hearing population. In response to this information a qualitative study sought to explore the health behaviors, beliefs, and factors influencing vaccine acceptance, hesitancy, and refusal among Deaf American Sign Language (ASL) users.

Methods: The study utilized ASL-recorded online informed consent, screening survey, and focus group discussion questions. The screening survey gathered demographic data, COVID-19 vaccination status, and language preferences. Participants were divided into two web-based focus groups: one consisting of COVID-19 vaccinated individuals and the other of those who remained unvaccinated. The semi-structured focus group sessions examined health behaviors, beliefs, barriers, and factors influencing vaccine decisions.

Results: A total of 38 individuals completed the survey, with 31.6% unvaccinated and 68.4% having received at least one dose of the vaccine. Among the 20 focus group participants, 20% were unvaccinated while 80% had received at least one COVID-19 vaccine dose. Preliminary findings indicated that vaccine-hesitant participants were primarily concerned about insufficient research and contradictory media messages. Those who received the COVID-19 vaccine reported facing communication barriers that complicated their access to the COVID-19 vaccination.

Discussion: Further analysis is needed, but initial findings highlight the importance of providing clear, consistent, and accessible communication in pandemic response efforts. The presentation will also include additional results from the continued analysis.

Background: Indigenous People in California, including American Indian/Native American (NA) and Indigenous migrants (IM), have faced barriers to accessing health information during the COVID-19 pandemic due to linguistic exclusion, technology barriers, and medical mistrust. Less research has examined how Indigenous People rely on their social networks, including online social media connections, to access information about the COVID-19 vaccine and protection for themselves and their families.

Methods: In this community-engaged research project, we conducted four in-depth focus groups with Indigenous People (NA= 8; IM=21) residing in California between June and September 2024: Purépecha-speaking adults (in-person); Spanish-speaking Mesoamerican IM (virtual); and English-speaking NA adults (virtual). Focus groups were facilitated by Indigenous team members and participants were asked open-ended questions about COVID-19, the vaccine, health information access, and social media use. Reflexive thematic analysis was used to examine data for themes.

Results: Four main themes were identified in relation to vaccine decision making:

• Decisions about vaccination are a progression and can include regret post-vaccination;
• Ties out-of-state or to transnational home communities influence access, sharing and decisions about health information;
• Need for accurate health information, especially tailored and targeted to Indigenous communities;
• Use of traditional medicine or remedies helped to protect health.

Conclusion: As one of the hardest hit communities during the pandemic, more focus is needed on how Indigenous People make health decisions. Targeted and tailored health information and traditional resources that are available in Indigenous languages and prepared in partnership with trusted Indigenous leaders and organizations are needed.

Background: Youth are often excluded in decisions regarding their health and healthcare. With increasing vaccine hesitancy and mistrust in science, the objective of this study was to investigate parental and adolescent perceptions of policies that allow adolescent self-consent to recommend vaccines. Although several states have passed legislation allowing minor consent to vaccines, it is unclear how adolescents and their parents perceive these policies.

Methods: This sequential mixed-methods study examined factors influencing vaccine decision making among adolescents aged 12-17 and their caregivers in the U.S. Using targeted intercept recruitment via social media we recruited a sample of participants, diverse in geographic location, COVID-19 vaccination status, and race/ethnicity. We conducted semi-structured interviews with 15 parent-adolescent dyads (n=30) exploring minor consent for vaccination. Using a hybrid deductive-inductive approach we conducted a thematic analysis, selecting illustrative quotes.

Results: Findings revealed important insights into perceived appropriate age of consent and concepts related to minor consent, including (a) the politicization of specific vaccines (e.g. COVID-19 and HPV), (b) fear of vaccine side effects if parents are unaware of adolescent vaccine uptake, (c) the role of parenting style on youth decision making, and (d) strategies for youth affirming patient-provider communication.

Conclusions and Implications: State-level vaccine policies authorizing minors to self-consent may be increasingly important as national vaccine funding is diminished. Our findings can provide useful guidance for the development of shared decision-making policies and practices that promote adolescent autonomy and provide guidance to support independent health decision-making for adolescents transitioning to age 18.

Harris County Public Health (HCPH) believes that access to life-saving vaccines should never be limited by income, zip code, or language accessibility. HCPH developed Harris County Vaccinates, a campaign launched with this vision in mind—designed to reach uninsured and underinsured communities of all ages.

The campaign meets people where they live, learn, work, and play—whether during commutes via radio, watching TV, scrolling through social media, or riding public transit. As over 145 languages are spoken at home in Harris County, messaging was intentionally delivered in English, Spanish, Vietnamese, Chinese, French, and Arabic to ensure accessibility in the top six spoken. Messaging was refined and tested based on engagement, using streaming media for precise tracking and traditional media such as transit ads to target high-need areas. Additionally, ad performance was tracked across channels, leading to a redesigned vaccine website for easier access to clinic and vaccination information.

HCPH developed a dashboard to track performance indicators, including reach, audience engagement, and vaccination appointments. At the campaign’s conclusion, surveys were distributed at health fairs and digitally to assess the campaign’s effectiveness.

As a result, we saw a rise in vaccination appointments at HCPH Clinics and greater media interest in our data—especially during public health concerns like the recent measles outbreak in Texas. Across divisions, our teams worked together to build healthier communities, proving that public campaigns not only inform but also inspire action to live healthier lives.

Background:
With the rise of social media, information dissemination has evolved, becoming a critical tool for not only connecting people but also facilitating public health campaigns. However, due to its ability to rapidly spread information, misinformation and skepticism about vaccination are often seen. In Louisiana, where vaccine uptake has historically been low, understanding the role of social media in shaping vaccine perceptions is crucial for designing effective public health interventions.

Methods:
We conducted social media listening using Meltwater and Google Alerts to analyze vaccine-related sentiments. A social media campaign was also developed to provide general education about disease symptoms, available vaccines to prevent infections, and vaccine side effects to Louisiana residents. Posts were published and then boosted for seven days.

Results:
We identified 15 noteworthy stories that signified a spike in sentiment, including users either opposed to vaccines or uninterested in hearing about them. Mistrust and concerns about safety were underlying themes. Our social media campaign reached 43,429 users, received 652 reactions, 62 shares, and 105 comments. Most of the audience was women, with Facebook engaging an older population and Instagram a younger one. Hepatitis B, Rotavirus, and MMR vaccine posts received the most attention.

Conclusion:
While social media is a key tool for public health campaigns, it has also contributed to distrust and misinformation, underscoring the need for a more culturally tailored approach to improve accessibility. Further research is needed to evaluate the impact of social media campaigns on reducing hesitancy and increasing willingness to adopt public health recommendations.

Background

People who inject drugs frequently lack access to care and may be reluctant to engage with providers because they fear stigma, disrespect, or mistreatment due to substance use. People who use drugs and speak a language other than English face additional barriers to communicating with even the most well-intentioned providers. To increase vaccination against COVID-19 and improve access among people who inject drugs, our team partnered with a community-based organization in East Harlem to create a tablet-based intervention, including a brief (<6 minute) video, in English and Spanish. We evaluated the effects of intervention language on vaccination by logistic regression.

Methods

We recruited 545 unvaccinated people via participant referral. All reported past 90 day injection drug use. Data were collected in a facility operated by our community-based partner. At the end of the tablet-based intervention, after the video, tablets asked participants if they would like to vaccinate. If participants clicked “yes” they were vaccinated onsite.

Results

Participants who completed the intervention in Spanish were significantly more likely to vaccinate post-intervention compared to people who completed the intervention in English. Among people who completed the intervention in Spanish, 7 out of 34 vaccinated (20.6%) compared to 38 out of 466 (8.2%) who completed in English (OR 0.396 [0.165-0.953], p = 0.039).

Conclusions

Spanish language content resulted in a much higher percentage of people vaccinating following a brief intervention. Non-English content may encourage deeper engagement, and thus, greater openness to intervention messaging among high-need, underserved populations.