Title: NIH Study to Determine if Childhood Disease Rates Higher in Vaccine Refusal Areas

A five-year, $1.7 million grant from the National Institutes of Health to study trends in American vaccine hesitancy and refusal has been awarded to a research team led by Shweta Bansal, a Georgetown assistant professor of biology.

Working with researchers from the University of Georgia and Pennsylvania State and Emory universities, Bansal will use data from health insurance claims to identify areas of the country where vaccine refusal is on the rise.

With anti-vaccine activists growing in number and influence in recent years, public health professionals have become increasingly interested in identifying where and why people refuse vaccines and how this behavior drives the spread of vaccine-preventable disease.

“We’re looking at how this behavior plays into disease emergence,” Bansal said. “Ultimately, we want to understand this process well enough to forecast it, and, in collaboration with our CDC colleagues, design policy to positively affect vaccination patterns and mitigate disease spread.”

Understanding Vaccine Hesitancy

The researchers will look specifically at the emergence and spread of childhood diseases such as measles, whooping cough and chicken pox in the areas people refuse to get their children vaccinated.

Rates of vaccine refusal are currently tracked at the state level by the Centers for Disease Control and Prevention, but these numbers, she said, are not especially useful for policymakers seeking to better understand the geographical trends. Bansal’s dataset includes information at the ZIP code level.

“To tackle the resurgence of vaccine-preventable diseases we first need to understand the distribution of vaccine hesitancy within the country,” she said. “The fine resolution of our data means we can geographically localize this behavior and associate it to social and economic characteristics of an area.”

Naysayers Highly Educated?

The team’s preliminary analysis of the socioeconomic profile of vaccine “refusers” has revealed that the practice is associated with areas inhabited by people who are college-educated.

“While there is previous work on what motivates individuals to engage in vaccine hesitancy, we don’t know much about the populations that tend to have higher rates of this behavior,” Bansal said. “But public health policy is made at the population-level. And our work will help us understand how to design and target effective population-level policies.”

Online Portal

Bansal and her collaborators also plan to share their findings through an online portal so policymakers may use their data as a surveillance tool.

“Public health decision-makers haven’t had access to high-resolution estimates of vaccination and vaccine hesitancy behavior data,” Bansal said. “We hope our tool will allow federal, state and county public health policymakers to study national and regional trends as well as drill down to focus on their locality.”

Eventually, Bansal hopes that this research will have an impact beyond U.S. borders.

“Vaccine hesitancy isn’t limited to the U.S.,” she said. “Vaccine-preventable diseases are on the rise in the UK and across Europe, and we hope that our work will ultimately inform local elimination in other developed settings and bring us one step closer to global eradication.”