Investigating Barriers to Vaccination Among Durham County’s Vulnerable Populations

Abstract

BACKGROUND As antivaccination movements increase in the United States, underlying structural barriers to vaccination are often ignored. This study examines barriers to vaccination in an adult population to uncover factors leading to vaccination rates in underserved populations. METHODS This study was approved by the Duke University Campus Institutional Review Board. Fifty-four patients at the Adult Immunizations Clinic of the Durham County Department of Public Health were interviewed throughout June and July 2019. Subjects were enrolled on a voluntary basis followed by oral consent. Eligible subjects included English-speaking adults receiving vaccines aged 19 or older. Anonymous and confidential interviews were conducted verbally. RESULTS This study found that a large proportion of study participants were referred by their provider to receive vaccines at the health department. It was also found that having a provider appeared to lead to a decrease in vaccine hesitancy. Enhanced patient understanding of vaccines was not necessarily contributing to the apparent decrease in vaccine hesitancy. Patients who understood the importance of public health had the same rate of vaccine hesitancy as those who had no reason for receiving vaccines. LIMITATIONS External validity is limited due to small sample size. CONCLUSIONS Health care providers may play an essential role in reducing vaccine hesitancy. However, increases in vaccine uptake due to provider-level interventions may not necessarily be due to an enhanced understanding of vaccines or their importance to public health.