P0120 - Cooperation between the Pediatric Emergency Department and the Pediatric Infectious Diseases Specialist to Counter Vaccination Hesitancy

Background: Vaccination hesitancy is a global public health threat. Pediatric emergency department (ED) practitioners often encounter patients who have not received adequate vaccinations due to hesitant parents. However, it is difficult to secure enough time in the ED to perform vaccination education. The National Center for Child Health and Development, a tertiary children’s hospital in Japan, initiated cooperation between the ED and the pediatric infectious diseases (ID) division to counter vaccination hesitancy. When ED doctors, who were educated to check vaccination history, identify vaccination-hesitant parents, they offer parents an appointment at a vaccination education clinic run by pediatric ID specialists. The clinic addresses parental concerns and provides thorough evidence regarding the pros and cons of vaccinations, averaging 1-2 hours per session. The purpose of this study is to reveal the prevalence of vaccination hesitancy at an ED in Japan and evaluate the utility of our vaccination education clinic.

Methods: A retrospective chart review of the patients who visited the vaccination education clinic from March 2018 to December 2019 was performed. Patients’ characteristics including age, sex, reason for the initial ED visits, and vaccination hesitancy, and outcomes of the vaccination education clinic were extracted from the medical records. The prevalence of vaccination hesitancy in the ED was estimated by the number of vaccination-hesitant patients/parents divided by the total ED patients under 6 years of age.

Results: During the study period, 36,183 patients under 6 years of age visited our ED. Among these, 58 patients/parents were found to be hesitant to vaccinations (the prevalence was 0.16%). The median age was 2.5 years and 34 (59%) were male. Ultimately, 18/58 (31%) patients visited the vaccination education clinic. The main reason for vaccination hesitancy was concern about side effects. We found that 13/18 (72%) of these parents obtained information regarding immunization through the internet. Six parents had been initially educated by physicians who were anti-vaccine activists. All parents who attended our vaccine education clinic replied that they gained a positive view on vaccination. Further investigation is needed to confirm whether vaccination had been performed after attending the clinic.

Conclusion: The ED is a useful place to identify vaccination-hesitant patients/parents. Vaccine education by pediatric ID specialists may be useful to change parents’ attitude towards immunization.