VaccineLink / La Salud Conexion: Successful Innovations with Vaccine Health Navigators (VHNs) to Identify and Overcome Vaccination Barriers In Underserved Communities

Background: In Florida, 4.07 million adults (20.1%) under the age of 65 remain without reliable health insurance. Two of the largest Florida counties (Hillsborough and Polk) have witnessed an increase in influenza and pneumococcal mortality reaching 9.4 and 12.5 per 100,000 population, respectively from 2005-2012. However, reasons for low vaccination uptake is unclear, especially among underserved and minority populations. Methods: Using a pre- and post- intervention 40-item bilingual Spanish/English cross sectional, 4-point Likert scale questionnaire on attitudes, beliefs, and barriers regarding adult vaccination, two Vaccine Health Navigators (VHNs) were deployed in Hillsborough and Polk counties, Florida, from January 2015 to June 2015 to diverse community centers to present consented educational interventions on adult vaccination using either spoken or video information on the Big 5 Vaccines (influenza, pneumoccal, Tdap, HPV, and meningitis) using a new “5 A’s” educational approach (Awareness, Additives, Autism Myth, Assist Others, and Accessibility). Results: Of the total 2143 interventions (224 mobile tablet and 1919 paper surveys), 1033 (53.8%) female, 836 (43.6%) African American, and 392 (20.4%) Latino. Of the 1791 (93%) in English, PreTest showed 428 (25%) agreeing that vaccines caused autism, and 1052 (59%) worrying about vaccinations safety. Vaccination barriers: “nothing” (n=872;49%), money (n=439;25%), and uncertainty for correct vaccination (n=318; 18%).  PostTest showed 95% agreeing that the Big 5 can cause sickness and death with a decrease to 370 (20%) agreeing that vaccines caused autism and 795 (45%) worrying that vaccinations were safe. PostTest vaccination barriers: “nothing” (n=965;54%), money (n=409; 23%), and vaccine uncertainty (n=154; 9%). Vaccination information was mostly from a physician (n=1339;76%) and least commonly per Facebook/social networks (n=168; 9%). Positive motivational factors contributing to vaccination were: self-interest to protect oneself against disease (n=1325; 75%) followed by desire to protect others (n=528; 30%). Conclusion: Intensive educational interventions on vaccine readiness are effective. Barriers to vaccination can be identified and decreased among diverse populations using culturally and linguistically appropriate educational interventional tools.