Fostering Trust in Pediatric Vaccinations with Gillette Children's

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Tom Haederle
For children's hospitals, fostering trust in the COVID 19 vaccines for pediatric populations is an essential part of their effort to protect families and their communities from the pandemic.

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Tom Haederle
Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle, with AHA Communications. In this new series on pediatric COVID 19 vaccine confidence, we'll hear from leaders from children's hospitals from across the country about their vaccine confidence efforts. Today, the AHA’s Julia Resnick, director of strategic initiatives, is joined by Dr. Micah Niermann, chief medical officer and pediatric physician at Gillette Children's Hospital in Saint Paul, Minnesota.

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Tom Haederle
As Dr. Niermann explains, Gillette Children's focuses on providing pediatric specialty care. But it's collaborative vaccine confidence efforts reverberates well beyond hospital walls. And now over to Julia and Dr. Niermann.

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Julia Resnick
Micah, thank you so much for joining us today to talk about pediatric vaccine confidence. To get started, can you tell me more about your hospital and the community that you serve?

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Micah Niermann
Yes, and thank you very much for having me here. So I work for Gillette Children's Hospital. So we are a specialty hospital. We take care of kids with rare, traumatic and complex conditions. We are celebrating our 125th anniversary this year. We were the first hospital of its kind in the United States. So we have a strong presence here both in St. Paul, where our main campus is, but also in the St. Paul Minneapolis metro area with several clinics, including Greater Minnesota with outreach clinics there as well.

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Julia Resnick
Wonderful. So you've been caring for some of the most vulnerable kids in your community. And I'm sure that COVID was a really hard time for all of them. So when the COVID vaccine became available for children, how did families in your community react to having access to that vaccine? And were there any concerns that you've been hearing about as it was rolling out?

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Micah Niermann
Yeah. So, you know, as you can imagine, there was a great deal of concern. This was all borne out of the parental and guardian concern for wanting what's best for their kids. A lot of the concern came around the fact that they just didn't know enough information about the vaccine. As you can remember during the pandemic, there was a lot that we didn't know and our information, our knowledge about the pandemic, the virus that was continuously evolving.

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Micah Niermann
But we also gave reassurance to families, too, that despite the newness of this pandemic and the virus, that the science behind being able to fight against it and the vaccine has been around for decades. And that despite the swift response that doesn't necessarily reflect, you know, the fact that we don't know what we're doing. Certainly the medical and scientific communities were heavily invested in making sure that we were addressing the pandemic in the safest and the most rapid way possible and trying to keep patients and families informed as best we could.

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Julia Resnick
So there was and there still is so much misinformation out there about the vaccines. What were you doing to counter all of that that was going on?

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Micah Niermann
Yeah, that's an excellent question. Again, a lot of the misinformation was based on fear and just the unknown. So one of the fundamental responsibilities we have speaking really as a physician, but I think this is true of health care systems, is that we need to educate our patients and families. To be able to do that also means establishing trusted relationships.

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Micah Niermann
When we talk about misinformation, what we want to do is understand best where patients and families are coming from, what their world perspective is of the pandemic and how they understand, you know, the knowledge that they have been given about the vaccine, about the virus, the pandemic. And then, as we understand it from their perspective, then bringing the information that we have that's based on data, based on science and being able to tailor that to their perspective.

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Micah Niermann
so that they understand the information better and can make better educated choices.

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Julia Resnick
So I want to pull on that thread about trust and what it takes to build trust in your community, not just for the vaccine, but in how you how you connect with them. So can you talk a little bit about how Gillette Children's has been partnering with community stakeholders throughout the pandemic?

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Micah Niermann
Yes. So, yes, thank you for the question. So to build trust, it means that you have to build a longstanding relationships. So our outreach into the communities in which Gillette is based, that outreach has been ongoing. It wasn't done just for making sure patients and families are getting vaccinated. So to give you an example for the St. Paul Boys and Girls Club, 

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Micah Niermann
there were groups of us as physicians who are doing outreach among the youth. They're in a mentoring program and talking about whatever questions they have around health. So already beginning to establish those relationships, knowing that we are a constant presence and we're committed. And then when there are opportunities like the ones that we had with the Boys and Girls Club, where the staff were setting up vaccination clinics, that allowed us to be able to provide more expertise and education for their staff, to be able to do outreach within the community.

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Micah Niermann
So those are just one just one example of how our community efforts really are built on longstanding establishment of relationships in order to be able to help the communities remain as healthy and viable as possible.

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Julia Resnick
That's really wonderful to hear that you were just able to build on those relationships and hopefully will be able to continue to build on them in the future. So thinking about your work with the Boys and Girls Club and how you message things in the community, how can we tailor those messages to foster vaccine confidence for diverse populations, especially as we continue to look forward and try to get as many people vaccinated as we can?

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Micah Niermann
Yeah, that is that is an incredibly important question. As you're well aware, I mean, in the United States, our vaccination rates are not where they need to be. If you look at certain areas of the population, if you look at the elderly, our vaccination rates are very good. But within children, especially young children, our vaccination rates are low.

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Micah Niermann
How do we improve that? We improve that by establishing those relationships in different communities, have different reasons and understandings for why they are not pursuing vaccines for their children. And so, you know, going back to what we talked about before, really trying to understand their worldview and then meeting them where they are is critically important. To give you an example in the community in which the Gillette's main hospital finds itself, you know, predominantly African-American, Hispanic, Somali.

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Micah Niermann
The understanding for those communities or the reasons why they may not be vaccinating their children could be very different from other communities. There are some similar threads as well, but much of what I had heard was also borne out in some of the data that comes from surveys, from the Kaiser Family Foundation, for example. And this can range from being unsure about what the long term effects of the vaccine could be on their children to, you know, for families and caregivers missing work because of concerns from reactions from the vaccines.

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Micah Niermann
So being able to address those and talk to those and and provide reassurance about the data that we do have and the fact that we're continuously monitoring and that the vaccines are safe, they're effective, and they do guard against significant complications from the disease, all really help to provide that reassurance and then also help to build those long-standing relationships that are based on trust and honesty and a commitment that you are there to help them in the community and that we're not just there to help us

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Micah Niermann
you know, just check off something on a list that we need to do for the community.

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Julia Resnick
And I think it's just so important to remember that in these situations, parents really just want what's best for their kids and want to make sure what they're giving their kids is safe. So really appreciate that perspective. So we know that the public health emergency is officially wrapping up, but that COVID is not yet over. So a lot of hospitals and clinics are going to be continuing this work to try to vaccinate their pediatric patients.

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Julia Resnick
So based on what you've learned over the past few years, what are the key lessons or takeaways that you think would be helpful to other communities looking forward?

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Micah Niermann
Yes, thank you. So the key takeaways are that that you have to be committed, that you have to meet people where they are. You have to understand where they're coming from and that this is really a long term effort to keep patients and families healthy. It doesn't mean because, you know, these larger efforts are coming to a close, doesn't mean there couldn't be another pandemic.

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Micah Niermann
It doesn't mean that COVID still isn't a significant health threat. All of those are very true. And we have to have strong established relationships and trust within the community to be able to address future issues and to be able to continue to improve vaccination rates on COVID as well as other infectious diseases. And it doesn't even stop there.

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Micah Niermann
I mean, we could talk about other aspects of health, whether it's heart disease, diabetes, asthma; all of those are affected by how well we establish relationships with our communities.

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Julia Resnick
Wonderful. And I know that you will continue to be to build those relationships with your communities. And I know the hospitals around the country are looking to do the same. So, Micah, thank you so much for your time and your insights. Really appreciate it talking to you and learning more about Gillette Children's efforts to improve pediatric vaccine confidence.

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Micah Niermann
Thank you very much, Julia. It's been my pleasure. I appreciate it.

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Tom Haederle
This podcast was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention. The contents of this resource do not necessarily represent the policy of CDC or HHS and should not be considered an endorsement by the federal government.