NACCHO’s Vaccine Confidence Initiative: A Report from the NACCHO Annual Workshop


Workshop attendees brainstorm messages for various audiences

Recent outbreaks of vaccine-preventable diseases and an increase in vaccine hesitancy in regions of the United States have emphasized why it is more important than ever for local health departments to communicate the importance, safety, and efficacy of vaccines. Although immunization rates across the United States remain high, many communities have pockets of unvaccinated persons. To assist local health departments and partners in designing messages for local use, NACCHO’s immunization team hosted a workshop titled, “Moving People off the Fence: Create a Local Communications Campaign to Increase Vaccine Confidence” on July 7 at the NACCHO Annual Conference in Kansas City, MO. Sixty-two local health department staff, representatives from the pharmaceutical industry, and public health association staff attended the workshop to strategize how to convey the importance of vaccines to their communities.

The workshop began with three speakers presenting on vaccine communication campaigns and strategies in their communities. Matt Zahn, MD, from Orange County Health Department (CA) spoke about efforts to combat measles and successfully communicate with the community during the 2015 multi-state measles outbreak. Attendees also heard from Lynn Royer, RN from Dallas County Public Health Nursing Services in Iowa about creatively and effectively using marketing, social media, branding, and reminder/recall to increase human papillomavirus (HPV), Tdap, and flu vaccination rates. She also discussed how Dallas County has partnered with the state to coordinate activities and communicate consistent HPV messages. Finally, Becky Sherman, BSN, MPH presented on Ashland Child, a website created by the local immunization coalition in Oregon to increase vaccination rates in the community. Ashland Child’s website features information and resources for parents about vaccines at a tenth grade reading level to reach its highly educated audience. Ashland Child received the 2013 Immunize Oregon Award for Communication and Promotion.

Following the speakers, attendees were led through an activity to identify community members who are “fence sitters.” These people do not have complete confidence in the vaccines recommended to them or their child and therefore defer or delay vaccination while continuing to seek out more information about vaccines. Attendees brainstormed potential fence sitter audiences in their communities and their defining characteristics. Groups then chose one audience to target in developing sample messages and described how they would deliver the message to their target audience. Attendees identified social media, TV, radio, community centers, grocery stores, parks, posters, and flyers as important vehicles for immunization messages.

Some notable messages that came out of the workshop include the following:

  • “Vaccines today are yesterday’s seatbelt”
  • “Facebook is not accredited. Get the facts on your health”
  • “Vaccines are more natural than you think!”

Attendees thought the workshop enabled them to brainstorm about the people in their communities in a unique way. Since vaccine refusal often occurs in pockets of communities, participants recognized the value in thinking specifically about audiences and the different messages that would resonate with each audience.

What Can Local Health Departments Do?

In developing a vaccine communications campaign to increase confidence in vaccines, it is important for local health departments to be proactive in communicating their message and to remember that knowledge is important, but not enough to change behavior. Communication is a two-way process, and it requires someone credible to deliver the message and someone to receive it, so take your audience into account when designing your message and choosing modes of delivery. Communications should be an integral part of any immunization campaign and messages should be used creatively to promote vaccine uptake and address the specific factors that influence hesitancy in your community.

If you are interested in learning how your local health department can address vaccine confidence within your community, please email or let us know in the comments section below. Learn more about vaccination communications and find resources to use in your community on CDC’s website at

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