Rapid Translation of Vaccine Hesitancy Data into Real-Time Guidance for Health Care Facilities

A Rani Elwy, PhD
Brown University

ABSTRACT:
Objective. To rapidly assess Veteran Health Administration employees’ and Veterans’ perceptions of COVID-19 vaccines and help leadership increase vaccine acceptance.

Data sources. 63 interviews with employees and Veterans (January-May 2021), and a cross-sectional survey of 1,178 Veterans across the United States (March 12-28, 2021).

Study Design. The quality improvement project involved concurrent mixed methods. Our embedded Rapid Response Team designed the project for dissemination, using a variety of strategies, to share ongoing results with VHA and Veteran leaders.

Data Collection/Extraction methods. We used directed content analysis to analyze interview data. Bivariate analyses tested for associations between vaccine intention groups (definitely will not, probably will not, not sure, probably will, definitely will), health outcomes and sociodemographic characteristics. Using mixed methods, we combined data to classify reasons for vaccine hesitancy into five categories: deliberation, dissent, distrust, indifference and skepticism. We identified trusted sources of information, and preferred modes of communication among different intention groups.

Principal Findings. Those unsure of COVID-19 vaccination were more likely to report fair or poor overall health, and to primarily report concerns about vaccine side effects, preference for natural immunity and less medicine use (vaccine skepticism). Reasons for getting vaccinated included the impact of COVID-19 on family, society and one’s own health. Disseminating results through frequent briefings, infographics, and Q&A sessions with VHA national, regional and local leaders, and Veteran Stakeholder Councils, we identified a need for action to turn hesitancy into acceptance. We collaboratively developed a 3-step communication plan for facilities to enable vaccine conversations in innovative ways, and submitted this to the VHA Innovation Ecosystem for further dissemination among VHA facilities.

Conclusions. Generating rapid, real-time evidence from Veterans and employees on their vaccine hesitancy was possible due to VHA partnerships. Data informed strategies for increasing COVID-19 vaccine acceptance that can be tailored to each facility’s needs.