Vaccine Acceptance

Two Emory Vaccine Center faculty conduct research to better understand vaccine acceptance and vaccine hesitancy. This work is crucial to vaccine policy and disease prevention because "vaccines don't save lives vaccinations do." -Dr. Walt Orenstein. Dr. Saad Omer's work includes clinical and field trials to estimate efficacy and/or immunogenicity of influenza, polio, measles and pneumococcal vaccines; studies on the impact of spatial clustering of vaccine refusers; and clinical trials to evaluate drug regimens to reduce mother-to-child transmission of HIV in Africa.  He has conducted several studies to evaluate the roles of schools, parents, health care providers, and state-level legislation in relation to immunization coverage and disease incidence.Dr. Bednarczyk's research focus is in the prevention of cervical cancer and other human papillomavirus related diseases through the use of HPV vaccination. Additionally, he has interests more broadly in vaccine acceptance, particularly for adolescent and adult vaccines.Learn more about Saad Omer's research.

Current Projects:

Tailoring of Vaccine-Focused Messages: Moral Foundations and Disease Salience

Vaccination of children of all ages helps protect them against a variety of diseases. Young children are especially at risk for contraction of and complications from diseases due to their vulnerable immune systems, while adolescents and pre-adolescents are a priority group for HPV vaccination. New evidence-based messages are needed to maintain and increase vaccination uptake among these groups. Our prior work has focused on how emphasis on different values is related to decisions parents make about vaccines. Now we are building off of this work to develop, implement, and evaluate messages that focus on different aspects of these values to impact vaccination attitudes among parents of young children. We are also evaluating the effect of emphasis on disease salience in HPV vaccine-focused messages among parents of pre-adolescents and adolescents.

P3+ Maternal Immunization Project:

Vaccination of pregnant women can impart health benefits on the unborn and infant child, and increased acceptance of maternal vaccination may lead to increase in acceptability of childhood vaccination. However, maternal vaccination rates are low, and new comprehensive, evidence-based interventions are needed to increase vaccination uptake among pregnant women and their children. We will build off of a prior intervention at the practice, provider, and patient levels (P3) to develop, implement and evaluate an enhanced intervention (P3+) to improve vaccination uptake among pregnant women, and later, their children.

Baseline Surveillance to Identify the Burden of Pertussis in Early Infancy in Pakistan

The proposed study is a phase one of the maternal Tdap project in Pakistan. Phase one will be the Surveillance Phase to estimate incidence of pertussis within the first 18 weeks of life, while evaluating disease severity. We will enroll a total of 2,021 infants (of these 200 will be in the closed cohort) aged between Day 0 (birth) and 10 weeks over a one year period.  In the open cohort study, we will enroll 1804 infants who are eligible (less than 10 weeks old) on day 1 of the study. Infants will be followed up through 18 weeks of age. In the closed cohort, 200 healthy pregnant women aged between 16 and 40 years old in their third trimester of pregnancy or women who recently delivered within the last 72 hours will be identified and eligible for enrollment based on the exclusion and inclusion criteria, for participation in the study after obtaining informed consent. Follow-up for their infant will begin at birth and continue through 18 weeks of life. The study will be conducted at sites managed by the Aga Khan University (AKU) in Karachi, Pakistan.

Community-Based Respiratory Syncytial Virus Mortality Study in Karachi, Pakistan

Formative Phase: The formative work will focus on ensuring the acceptance of study procedures within the communities, assessing the benefits to families of deceased infants for participating in the study and assessing the feasibility of conducting a community based study to evaluate infant deaths due to RSV in Pakistan.

Impact Study

Workin to develop an evidence base for the implementation of immunization exemption legislation through 1) analyzing rates, clustering, and variances of immunization exemptions before and after California senate bill 277 removing believe exceptions (SB277) implementation, 2) evaluating the motivations, attitudes, beliefs, and health care practice burden relating to vaccinations in the context of SB277, 3) assessing the determinants and implications of variability in implementation and enforcement of legislation at the school level, and 4) ascertaining the impact of SB277 on the rates of home schooling. Ultimately, we will develop an evidence base for the implementation and effect of immunization legislation that has the potential to guide decision-making at the state and national levels. 

Overview

Vaccine policy projects at the EVC involve the conduct of vaccine trials and large-scale surveillance of vaccine preventable diseases including trials of maternal influenza immunization, pneumococcal, polio, and measles vaccines in addition to studies to evaluate the roles of schools, parents, health care providers, and state-level legislation in relation to immunization coverage and disease incidence. Other activities include policy analysis on pandemic influenza preparedness, studies on immunizations systems and emergency preparedness, and a study to evaluate Knowledge Attitudes and Practices of health care providers in India regarding routine immunization and polio-related supplementary immunization activities.