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Overcoming Barriers for the COVID-19 Vaccine for Kids

On October 29, 2021, the FDA authorized usage of the Pfizer-BioNTech COVID-19 vaccine for children ages 5 to 11-years-old. This was followed by the CDC’s announcement four days later recommending the pediatric COVID-19 vaccine for the 5 to 11 age group. Now that 28 million more Americans are eligible to receive the vaccine, healthcare organizations must play an important role accelerating vaccinations and decreasing the spread of the virus.

Routine child immunizations have declined over the last few years and have continued to drop since the emergence of a new virus. Recent data from the World Health Organization (WHO) indicates that in 2020, over 23 million children missed out on basic vaccinations, which is 3.7 million more than in 2019. Children make up a large segment of the U.S. population and can substantially advance the spread of COVID-19, elevating the need to promote vaccine awareness to parents of eligible children.

To increase vaccination among 5 to 11-year-olds, it’s important to first understand what causes vaccine hesitancy in parents. Social determinants of health (SDOH), misinformation, and health access are a few factors that influence vaccine hesitancy, and healthcare organizations can overcome obstacles like these by incorporating behavioral science strategies when communicating with parents. Overcoming vaccine barriers requires that parents are engaged with the appropriate educational resources that inspire behavior change and promote self-efficacy.

Understanding the Importance of Vaccinating 5 to 11-year-old Children

In the United States, there are over 72 million children under the age of 18, accounting for roughly 22% of the total population, according to a recent report from the U.S. Census Bureau. While the 12 to 17-year-old population is 51% fully vaccinated, those numbers are declining. The addition of 5 to 11-year-olds into the population of eligible Americans means that 28 million new patients are now able to be vaccinated. The data suggests that there are over 40 million children yet to be vaccinated, and well over half of them are between 5 and 11-years-old.

The urgency with vaccinating these children lies in the threat of widespread COVID-19 infection. 5 to 11-year-old children represent a large portion of the population across the U.S., and more importantly, they can infect vulnerable groups around them unknowingly through asymptomatic spread. Additionally, as the virus spreads throughout the community, the emergence of a more contagious COVID variant becomes increasingly likely. This complicates the pandemic by not only by bringing this unknown factor into the equation but by also potentially threatening the efficacy of existing vaccines for the greater population.

Beyond the threat of the coronavirus itself, however, required social isolation has contributed to loneliness and anxiety in children. The National Institute for Health Care Management Foundation (NIHCM) reported that from mid-March 2020 to October 2020, mental health-related Emergency Department Visits for children ages 5 to 11 had increased 24% compared to the previous year. Returning to a normal, pre-pandemic lifestyle may be critical to protect the long-term mental health of children.

So, if vaccinating the youngest eligible population is a step in the direction of normalcy, what is stopping parents from acting?

Identifying Barriers That Cause Vaccine Hesitancy

Perhaps the most apparent obstacles in the way of widespread vaccination among 5 to 11-year-old children are the education level, healthcare access, and health beliefs of the parents. In a study from Northwestern University that surveyed over 1,900 parents, it was found that those who received less education were less likely to vaccinate their kids. Fortunately, insights from older populations demonstrate that personal health beliefs and misinformation can be mitigated by providing adults with accurate COVID-19 information from trusted health experts and trusted channels of communication.

Lack of healthcare access can prevent parents from receiving vital communication about the free cost of the vaccine, locating vaccination sites, or how safe the vaccination itself can be (91% effective in preventing COVID-19 in children ages 5-11 years-old). Those populations with lower incomes are less likely to have healthcare coverage, which ultimately negatively influences vaccination rates.

When evaluating low access to COVID-19 resources, understanding how race and SDOH influence program utilization can help illuminate the best strategies to reach a parent. The aforementioned study also found that when it comes to vaccinating their children, Black American parents were the most hesitant racial group. This presents an opportunity to deliver more personalized interactions that scale across diverse populations. In order to do that, it becomes necessary to engage parents with culturally sensitive and accurate vaccine information.

Each individual parent has unique beliefs and preferences that influence how they engage with a COVID-19 program. Barriers like misinformation, SDOH, and health access can significantly impact vaccine hesitancy. While these are ingrained beliefs and difficult obstacles to overcome, healthcare organizations can adopt strategies to uncover these barriers and inspire healthier actions through meaningful conversations tailored to each individual’s unique beliefs and barriers.

Overcoming Barriers with Behavioral Science

The barriers that create COVID-19 vaccine hesitancy in parents are similar to the barriers that have long existed with traditional immunizations like influenza. Just like with the flu, an individual’s preferences can be understood by incorporating behavioral science strategies like social proof, authority, perceived effort, and affect.

Social proof is a concept derived from the Self Determination Theory, which suggests people can be motivated by their psychological needs for autonomy, competence, and relatedness. Giving people social proof, such as stories from parents like themselves who have already vaccinated their own children, ensures parents that they are not alone.

Authority is the inclusion of trusted health experts to improve vaccine education and reduce misinformation. When vital information is shared through clear and convenient conversations, organizations can begin to build trust with parents and drive health literacy.

The idea of perceived effort stems from providing accessible resources like FAQs or vaccine finder. This concept inspires self-efficacy by empowering parents to learn more about COVID-19, making it easier to take action.

Finally, incorporating a concept like affect ensures that messaging to parents is based in empathy and compassion. Communication should exhibit sensitivity to ensure parents feel comfortable discussing their child’s healthcare.

By gathering data directly from parents through behavioral science, healthcare organizations can tailor conversations according to the parent’s preferred language and preferred channel of communication.

Tailoring Conversations and Content to Drive Vaccine Readiness

All the behavioral science theories above can be employed when building an effective vaccine engagement strategy. One way healthcare organizations have begun fighting vaccine hesitancy throughout the last year is by utilizing Conversational AI solutions and streaming health content to educate their populations.

Personalized interactions with parents offer insights into how to keep them engaged with a program. By leveraging Conversational AI solutions, organizations can scale the number of conversations they are having while ensuring messages are tailored to each recipient. When employing two-way dialogue, unique barriers can be tackled by providing appropriate health resources and information to challenge their beliefs. One health plan saw member response rates of 19% for a COVID-19 vaccine engagement program. The plan understood that certain healthcare consumers may not respond to traditional methods of communication, enabling new and innovative approaches to lift vaccine awareness and readiness.

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By providing streaming health education to parent populations, they can easily access a library of COVID-19 learning content from trusted health experts. The easily digestible nature of streaming educational videos and podcasts makes it easy for both parents and children to follow along. The adoption of tailored conversations and rich, learning content yields a 69% average completion rate of on-demand COVID-19 content.

While engagement is necessary to improve vaccine education, providing a tailored learning experience is driving the most impressive outcomes related to program satisfaction. Personalization inspires program engagement that scales populations and is helping health plans achieve results like 70% member satisfaction. When healthcare organizations deploy educational COVID-19 video content, they encourage parents and children to learn more about the vaccine while positively impacting consumer experience.

Parents should be met with meaningful dialogue and content that is convenient to them. The use of behavioral science enables the understanding of parents’ personal beliefs and preferences, helping uncover barriers and information gaps. By incorporating tailored conversations and streaming content, healthcare organizations overcome those barriers, creating a seamless consumer experience that lifts health literacy and self-efficacy. Parents who are empowered with accurate health information and accessible resources can reduce vaccine hesitancy and significantly improve vaccine readiness for their children.

Recognizing Innovation in Healthcare at Activate2021

We recently hosted our annual conference, Activate2021, which featured a keynote address from Nick Webb, healthcare futurist and best-selling author, along with a number of exciting sessions, panel discussions, and of course–Activate2021 Awards!

The Activate Awards shine a light on healthcare organizations who are delivering excellence in health engagement to meet and exceed the needs of an evolving healthcare landscape. Never has this proven to be more fitting than in the past year when organizations have had to alter their consumer outreach strategies in response to Covid-19. With the disruption caused by the pandemic, it is now more important than ever to address gaps in communication and low utilization of services. 

These companies demonstrated how innovative ways to activate their populations can improve access to healthcare and significantly enhance the consumer experience.

Winners were decided based on qualitative and quantitative results across five categories: Health Equity, Conversational AI, Innovation, Outcomes, and Consumer Experience. In case you missed it, we’ve recapped for you the ways these 6 different healthcare organizations are making a powerful impact on health engagement, health equity, and health outcomes.

CalOptima – Improving Health Equity

CalOptima is a large, county-based health system that offers health insurance for low-income residents of Orange County, California. The plan sought a solution to uncover barriers to getting the Covid-19 vaccine and to increase vaccinations of its diverse Medi-Cal population. CalOptima rolled out a Covid-19 vaccine engagement program across 6 languages that geo-targeted highly impacted groups and delivered over 1.4 million tailored messages to members. 389,648 members received vaccinations with health equity efforts among populations of color resulting in CalOptima’s Black Medi-Cal population reaching a 45% vaccination rate compared with only 40% of Black Medi-Cal members vaccinated statewide. Similarly, 56% of their Hispanic Medi-Cal members are vaccinated versus 54% of Hispanic Medi-Cal members statewide.

CareSource – Best Use of Conversational AI

CareSource is a health plan, headquartered in Ohio, dedicated to member-centric insurance coverage for its 2 million members. Looking to combat vaccine hesitancy, the plan implemented tailored SMS messaging, member surveys, and streaming health content to educate and uncover member barriers to getting the Covid-19 vaccine. The campaign delivered over 3 million automated tailored dialogues to 664,000 members, with members self-reporting as “Non-Believer,” “Unsure,” or “Ready.” By tailoring communication based on member preferences, CareSource was able to impact more than 650k members nationwide. At the end of the program, 57,000 out of 107,000 “Unsure” members moved into the “Ready” persona.

Magellan Rx Management – Most Innovative Program

Magellan Rx Management, part of Magellan Health, is a national pharmacy organization that serves complex populations. Magellan Rx engaged their specialty pharmacy members with two-way messaging and digital fotonovelas to address loneliness and anxiety experienced by their members during the pandemic. The use of fotonovelas was an innovative approach to deliver easily digestible and educational content in an engaging, story-based format that is relevant across diverse populations. After incorporating conversational dialogues and fotonovelas, the most impacted populations were younger members and members most impacted by social determinants of health. Overall, the program yielded over a 38% engagement rate to go along with a 90% member satisfaction score.

CountyCare Health Plan – Most Significant Outcome (tie)

CountyCare Health Plan is a large Medicaid managed care organization offering no-cost health insurance to eligible members in Cook County, Illinois. The plan wanted to uncover obstacles preventing members from getting vaccinated while increasing awareness and readiness. CountyCare launched a vaccine engagement program that targeted members significantly impacted by social determinants of health. The program utilized digital fotonovelas to address vaccine hesitancy and lift health literacy. After over 2.6 million tailored messages sent, 18% of members replied or clicked a link and 72% said they are more likely to get the vaccine.

Providence Health & Services – Most Significant Outcome (tie)

Providence Health & Services is a nonprofit health system, based in Washington, that operates in seven states and serves millions of individuals. The health system sought to increase sign-ups for their MyChart eCheck-in Program, which centralizes appointments, prescriptions, bills and other important patient resources all in one place. By partnering with mPulse and optimizing their patient engagement strategy, with the SMS solution, they grew patient activation rates from 9.9% in December 2020 to 27.4% by August 2021.

A leading Health Services provider – Most Improved Customer Experience

This organization is a nationally recognized leader in technology-enabled health services with over 100,000 employees worldwide. The company needed to transition a wellness coaching program from telephonic to a fully digital experience. A focus of the program included delivering a tailored, content experience that scales across populations. The health services company partnered with mPulse to build 11 custom content courses that drove 120k enrollments, and it yielded a 75% completion rate along with an average engagement rate of 51 minutes per enrollment. The organization used digital tools to deploy a robust program that kept their health consumers more engaged with their health content for a longer period and moved them into a space that allowed for more meaningful engagement in the future.

These 6 healthcare partners harnessed the value of innovative engagement solutions and streaming health education to positively impact their populations. The programs illustrate how rapidly health engagement is evolving to meet the needs of a shifting healthcare landscape and through adoption of new capabilities that create more meaningful touchpoints with members. For more information about the Activate Awards or any of the capabilities used in these programs please email us at

About mPulse Mobile: mPulse Mobile is reimagining health engagement to inspire healthier lives and deeper relationships between healthcare organizations and their consumers. Healthcare’s leading Conversational AI platform combines with award-winning health education for the streaming age to deliver tailored educational health engagement that nurtures, educates, and activates healthcare consumers.

With more than a decade of experience, 125+ healthcare consumers and 500 million conversations annually, mPulse Mobile has the data, expertise and the solutions to drive healthy behavior change.