NOSI: Research to Address Vaccine Hesitancy, Uptake, and Implementation Among Populations that Experience Health Disparities

Program Description

NIMHD supports this Notice of Special Interest (NOSI) that highlights the need for research strategies and interventions to address vaccine hesitancy, uptake, and implementation among populations who experience health disparities in the U.S. and its territories.

The purpose of this NOSI is to solicit community-engaged research to:

1. Evaluate intervention strategies to facilitate vaccination uptake in the clinic and community.
2. Address the barriers to increasing reach, access, and uptake of vaccinations among health populations experiencing health disparities at high risk of serious illness and death from COVID-19 infection and likely to experience vaccine hesitancy.

Vaccine hesitancy, including both a delay in acceptance, or declining immunizations despite their availability, is higher for populations experiencing health disparities. The reasons for hesitancy are varied, but may include concerns about perceived safety, skepticism about the trustworthiness of the source(s) of vaccination recommendations, misinformation, difficulty accessing services, cultural or religious beliefs discouraging vaccination, among many others. The recent outbreak of Coronavirus Disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), highlights the need to develop and evaluate strategies to increase vaccine uptake and completion.

This NOSI encourages applications that considers upstream factors (e.g., health system, policy, etc.), as well as relevant cultural and historical factors associated with individual beliefs, risk perceptions, and behaviors across multiple levels (e.g., individual, community, etc.). Studies are needed to understand and address misinformation, distrust, and hesitancy regarding vaccines (e.g., SARS-CoV-2, pneumococcal, influenza, hepatitis B, human papilloma virus (HPV), and herpes zoster) among adults (and in children ages 9 years and older with respect to HPV) in the US and territories. Studies are especially needed in populations at increased risk for morbidity and mortality due to long-standing systemic health and social inequities and chronic medical conditions across the lifespan. Applications on urgent vaccination topics such as the SARS-CoV-2 vaccine are highly encouraged.

NIMHD supports studies that move away from an exclusively "top-down" public health vaccination approach by emphasizing collaborative partnerships with key stakeholders, including community partners and leaders, and leveraging existing partnerships to enhance vaccine access, delivery, and uptake. Applicants should have a history of successful recruitment and retention of participants within the populations of focus and proposals should engage community stakeholders through the research process, emphasizing community-based participatory research (CBPR) practices.

Projects should also incorporate strategies to:

1. Address individual and structural social determinants of health (SDOH) that present barriers to vaccine access and uptake.
2. Create sustainable collaborations and implementation in communities disproportionately affected by illnesses for which vaccination is an option.
3. Conduct effective communication, co-creation, and dissemination activities to inform communities about the project and findings.

Projects, particularly those addressing COVID-19, are strongly encouraged to use the SDOH Collection of the PhenX Toolkit, and the NIH Public Emergency and Disaster Research Response (DR2).  

Research topics of interest and key questions include (but are not limited to):

• Determining baseline rates of hesitancy for the SARS-CoV-2 vaccine and using this information to evaluate innovative interventions to reduce concerns and facilitate uptake.
• Understanding how evidence-based interventions that have reduced vaccine hesitancy and increased both access and uptake of other vaccinations (e.g., influenza and HPV) be adapted and/or adopted to increase the uptake of the SARS-CoV-2 vaccine.
• Conducting interventions using proven implementation approaches and frameworks (e.g., RE-AIM (Reach, effectiveness, adoption, implementation, maintenance).
• Evaluating how can vaccine-related communications on coronavirus, HPV, influenza, and other vaccines be generated and promoted by clinicians and healthcare systems to be community and culturally appropriate.
• For the full list of key topics, please consult the NOSI announcement.

NIH Guide No.: NOT-MD-21-008

Page updated February 9, 2021