Dr. Feemster and her team have conducted several studies to better understand vaccine initiation barriers related to vaccine hesitancy and how to overcome them:

1. A 2009 study of newborns from a large urban setting found that children most at risk of late vaccine initiation are those whose mothers attend fewer prenatal care visits and who are younger, less educated and already have at least one other child. These delays may not be driven by negative attitudes toward vaccines, but demonstrate that barriers to accessing vaccines combined with an underappreciation of the severity and prevalence of preventable diseases can keep children from being fully vaccinated on time. Dr. Feemster’s findings suggest that it is critical to target at-risk mothers early, even prenatally through vaccine education and to encourage prenatal pediatric visits. These data also highlight the potential for immunization registry data to identify infants for targeted outreach. 
2. PolicyLab researchers Dr. Alex Fiks and Dr. Feemster evaluated the feasibility and impact of interventions informed by behavioral economics (retail pharmacy vouchers for Tdap vaccines and a celebrity public service announcement) to increase Tdap vaccination among caregivers of young infants. They found that despite leveraging existing infrastructure for adult vaccination, the results suggest that retail pharmacy vouchers delivered during a newborn visit are not an effective strategy for promoting Tdap. Furthermore, alternative approaches are needed that prioritize convenience and provide an immediate opportunity to vaccinate when motivation is high.
3. Caregivers often ask for an alternative immunization schedule that spreads immunization over a longer period of time. Dr. Feemster and colleagues recently examined the characteristics of pediatricians and practices associated with different practice-level responses to alternative immunization schedule requests. They found that pediatricians who work in practices that accommodate alternative immunization schedule requests have increased odds of having a high frequency of alternative immunization schedule requests, and beliefs that relationships with families would be negatively affected if they refused requests while practices that discontinue care to families who request alternative immunization schedules have increased odds of being a private group practice and having a formal office vaccine policy.