Vaccines are one of the most powerful and cost-effective public health interventions in the history of medicine. Each year, vaccines save millions of lives and billions of dollars in indirect costs. Yet in the U.S. alone, about 42,000 adults and 300 children die of vaccine-preventable diseases (not including COVID-19) each year. And underserved populations, such as families who are underrepresented minorities and those experiencing poverty, are more likely to have lower rates of childhood vaccination – worsening already significant health disparities.

So many illnesses and deaths could be avoided if more children were vaccinated for routine diseases in a timely manner. Yet vaccine hesitancy is a persistent problem; in 2019, the World Health Organization named it as one of the ten most important threats to health globally.

The COVID-19 pandemic only exacerbated hesitancy regarding routine childhood vaccinations. Between March and May 2020, when most places were under stay-at-home orders, administration of routine childhood vaccinations in the U.S. was significantly lower than the same time period in 2018 and 2019, by as much as 71.3% in some cases. Vaccination rates bounced back later in 2020, once stay-at-home orders had been lifted, but not enough to make up for all the missed doses. Additionally, COVID-19 has sparked new conversations, concerns, and opportunities for misinformation to spread about vaccines.

Vaccine hesitancy is ripe for behavioral intervention. Over the past several years, ideas42 has examined this problem and explored ways to increase uptake and timeliness of childhood vaccines. We’ve done deep dives into the academic literature and existing field research, as well as conducted research of our own through a combination of surveys and interviews with parents, providers, and other stakeholders. Through this work, we’ve identified cross-cutting behavioral barriers keeping people from taking up vaccines, as well as promising solutions.

The problem of vaccine hesitancy and delayed or missed childhood vaccinations is seemingly intractable, and there’s no silver bullet for addressing it. Many adept problem-solvers have been tackling vaccination rates for years, and yet the problem persists. Applying a behavioral science lens sheds light on barriers that may be overlooked, and can contribute innovative solutions.

The behaviorally informed recommendations below can help increase vaccination rates [1]. They are not targeted to any one specific implementing body; they require action from many groups, across sectors, such as obstetricians, pediatricians, pharmaceutical companies, and community groups, to name a few. A multi-pronged approach is necessary to move the needle on such a difficult behavioral problem. We have categorized the suggestions below by target audience able to implement them, though some of them could certainly be adapted to work well for a variety of actors. Some of these appear in more than one category, but we’ve duplicated them to provide full slates of recommendations by audience.

Read the full article about childhood vaccinations by Arielle Gorstein at ideas42.