Using a Harm Reduction Model to Reduce Barriers to Vaccine Administration

Abstract

Vaccination is a strategic public health measure designed to reduce the adverse effects of many infectious diseases. Although national recommendations exist for vaccine administration across the life span, immunization rates are affected by barriers to vaccine access and hesitancy in vaccine acceptance. Midwives and women's health clinicians are optimally poised to assess their client's vaccination status and provide vaccinations during clinical encounters. In order to address client concerns about vaccine safety and administration, each clinician is expected to be knowledgeable about vaccine benefits, recommendations, side effects, and potential adverse reactions. Socioeconomic factors, social policies, and historic and continued experiences related to racism have been identified as barriers to ready access to vaccinations and vaccine acceptance. Midwives can act as leaders within their practice sites and communities through participation in projects that reduce barriers to vaccine access and uptake. Community vaccine outreach programs and relationship‐based care can increase vaccine uptake through improved health literacy and associated behavioral changes including greater vaccine acceptance. This article focuses on identifying barriers to vaccine uptake and describing harm reduction measures designed to improve uptake of vaccines. A variety of leadership activities are discussed that can improve clinicians’ understanding of their role in optimizing vaccination.

Vaccination in pregnancy: Healthcare provider attitudes and practices

“…Other members of the healthcare team are an invaluable resource that can be employed to provide vaccine counseling and re‐counseling in scenarios where a physician HCP may have limited time. 18 …”

“… 11 These strategies may help to ensure that more US prenatal clinics have the capacity to provide recommended vaccines, thereby reducing the burden on patients to accept vaccination. 18 …”

“…5,14,17 members of the healthcare team are an invaluable resource that can be employed to provide vaccine counseling and re-counseling in scenarios where a physician HCP may have limited time. 18 Documentation for vaccination counseling, vaccine uptake, and rationale for vaccine decline is not always performed by HCPs. Furthermore, when a patient is vaccinated at a third-party site such as a pharmacy, there is no system for record of this vaccination to be shared with the provider.…”

Screening for Information Environments: A Role for Health Systems to Address the Misinformation Crisis

“…Midwives for example, also advocate the need for harm-reduction approaches to misinformation, in particular about vaccines. 15…”

“…Midwives for example, also advocate the need for harm-reduction approaches to misinformation, in particular about vaccines. 15 Of course, despite patient portals and electronic messaging, the size of primary care panels renders it impossible for most primary care clinics to realistically be the sole source for patients' medical questions. But through screening patients for their information environments like other SDoH, we can draw in better information resources as needed and engage patients in a process of behavior change over time.…”