Vaccines are a central component of preventive care for populations of high priority to the NICHD. NICHD's priority populations include infants, children, adolescents, pregnant and lactating women, and persons with physical and intellectual disabilities, particularly those who are also underserved or experience health disparities. Strategies that promote access, acceptance and uptake of CDC-recommended vaccines among these populations have the potential not only to reduce the incidence of vaccine-preventable diseases, but also to promote health and well-being and to improve trust in science and health care. The ongoing COVID-19 pandemic makes this initiative especially timely because many jurisdictions seek to effectively deploy vaccines against COVID-19 as they are approved and become more readily available for children. Furthermore, insights gained from this initiative may inform efforts to ameliorate declines in rates of routine childhood and adolescent vaccine delivery.
The reasons for lower rates of vaccine uptake are varied, but include concerns about vaccine safety, possible long-term side effects, the potential for interactions with prescribed medications, and pre-existing conditions or disabilities. These concerns can be compounded by lack of vaccine acceptance due to skepticism regarding the accuracy or completeness of available information, low perceived risk of infection or severe illness, low perceived efficacy of available vaccines, beliefs regarding other preventive strategies against vaccine-preventable infections, or high perceived risk of adverse events. Finally, structural and historical factors, including costs and systemic barriers that impede access to care, can all have the common end effect of decreasing rates of vaccine access. Social determinants of health (SDoH), defined as the conditions in the environments where people are born, live, learn, work, play, worship and age (https://health.gov/healthypeople/objectives-and-data/social-determinants-health), intersect with these structural and historical factors in ways that also influence rates of vaccine access, acceptability and uptake. For many NICHD priority populations, vaccine uptake has added complexity because the person providing consent for vaccination may not be the person receiving the vaccine.
This NOSI encourages applications that address dimensions of access, acceptance and uptake of CDC-recommended vaccines among infants, children, adolescents, pregnant and lactating women, and persons with disabilities, especially among populations who are underserved or experience health disparities.
High priority applications will focus on NICHD-priority populations and issues that include but are not limited to the following:
- Research to identify age-, geographic-, and culturally-specific approaches to reducing barriers to vaccine access and increasing vaccination acceptance and uptake.
- Community-engaged research to identify strategies most likely to increase vaccine access, acceptance and uptake. This includes proposals utilizing trusted health, education and social service providers; training lay community members; and/or implementing models of shared decision-making to address concerns about vaccine safety or efficacy.
- Research to examine and address understanding of communication, education, or other engagement strategies on vaccine uptake decision-making, including the impact of misconceptions, misinformation, risk perceptions, and trust in vaccine recommendations.
- Research using social media, digital marketing, mobile applications, or other innovative technologies to identify and address institutional, structural or individual-level barriers to vaccine access, acceptance and uptake, including accessibility, discrimination, and misinformation, distrust, fear, or stigma regarding vaccines.
- Research using innovative data collection methods to identify, prioritize and reach specific population sub-groups for vaccine interventions.
- Research to identify how social determinants of health (SDoH) may exacerbate or mitigate disparities in vaccine access, acceptance and uptake for specific NICHD priority populations.
- Research to identify interactions between factors, including policy interventions, that impact vaccine acceptance and uptake and factors associated with other known health disparities among NICHD priority populations.
- Research utilizing dissemination and implementation methods to expand or accelerate the reach of efficacious interventions for improving vaccine access, acceptance and uptake in clinical and community settings, including primary care, childcare, school, pharmacy, and other community-based venues.