Sara Conners graduated high school during the onset of the COVID-19 pandemic. When time came to get the vaccine, she called it a no-brainer.

Her mother was born in India, and Conners was raised to understand the importance of vaccines.

“She was able to see firsthand diseases that are vaccine preventable,” Conners said of her mother’s upbringing.

Now, Conners is part of a team of UNLV faculty, students, and alumni who are working to educate Nevadans and improve confidence in childhood vaccines.

That means looking at the reasons why they aren’t getting vaccinated.

Nationwide, families are allowed to claim medical or religious exemptions from vaccines. In Nevada from 2023-24, that rate of exemptions was 6.7%, double the national average, according to data from the Centers for Disease Control and Prevention. Only 0.5% of exemptions were medical.

The Nevada Vaccine Confidence and Demand Improvement project, a joint effort with the Nevada Division of Public and Behavioral Health and funded by the CDC, will work through the end of June to use social media to address vaccine hesitancy among parents of Nevada children.

“Vaccines protect our entire population,” said Brian Labus, associate professor in UNLV’s School of Public Health and the lead faculty member on the project. “We’re talking about not just the health of one individual but the health of Southern Nevada, the health of Nevada. We don’t want to be a place that is constantly challenged by diseases where people are sick all the time. The goal is to have a healthy population so people don’t have to think about these things.”

Understanding vaccine hesitancy

After Kristina Mihajlovski received her doctorate in Serbia, she went to Egypt and Morocco on a medical exchange program and saw the ways in which different healthcare systems, with disparities in resources, impacted certain communities’ access to antibiotics and preventative healthcare.

“The concept of having ancient diseases still present in the modern world … it’s interesting how we can prevent them today, but lack of knowledge and lack of resources is something that’s preventing people from getting it,” she said. “It’s also interesting seeing some countries where they don’t have access to vaccination and how much they would appreciate having that.”

Mihajlovski moved to Las Vegas to get her Master of Public Health at UNLV, and now works as part of the vaccine confidence team focused on epidemiology and data.

A community achieves herd immunity when a certain percentage of its people are vaccinated or immune to a contagious disease, subsequently protecting those who are immunocompromised or can’t be vaccinated. 

Herd immunity for a disease can vary depending factors like basic biology, math and the effectiveness of a vaccine. Preventing community spread of a disease like measles, typically requires achieving a herd immunity rate of 95%.

Mihajlovski noted that unvaccinated people often don't realize the role that herd immunity plays in their health. It's like people unable to tell that it’s raining, she said, because others next to them are holding an umbrella that shields them from the rain.

Nearly all Nevada children two years and younger had at least one vaccine dose, the team found, but a significant portion did not complete the full series of their vaccines.

After several weeks of researching the demographics of Nevada parents and children who may be vaccine hesitant, the team has developed marketing materials, social media pages, and launched a website to begin disseminating resources and correcting misinformation related to vaccines.

Connors hopes social media will allow the team to break through to audiences on the platforms they’re currently using.

“If people could purchase the vaccines on Amazon and get it shipped to their door, they’d probably do that,” Conners said. “Shifting the focus from traditional ways of reaching out to being very social media heavy, it will allow people from most demographics to have access to this information.”

Tailoring their messaging means understanding why these parents don’t complete their child’s vaccine series — whether it’s mistrust in their child’s pediatrician or socioeconomic factors like the lack of transportation or time to make it to subsequent vaccine appointments. 

Juli Miller, the team’s project manager, likened completing a vaccine series to putting on your child’s helmet without securing and tightening the strap.

“Finish what you started,” she said. “This project is really meant to help people feel confident in finishing that protective measure.”

‘Finish what you started’

Miller raised her youngest son – who has autism – at a time when the controversial Wakefield vaccine study first generated attention by linking vaccines to autism. The study was later retracted after an investigation found several elements of the study were incorrect.

Her son is now 21 years old, and Miller said the experience taught her how to continuously educate herself and talk to trusted individuals, while also vetting the source of the information..

The COVID-19 pandemic exacerbated the issue of vaccine misinformation, with a different rollout and communication about the vaccine due to the public health emergency, Labus said.

“A lot of people have found each other as a result of COVID-19, so there’s this group of people that just don’t believe in vaccines,” he said. 

But fear over the side effects of the vaccine have seemingly replaced fear of the diseases themselves, a testament to the preventative work that public health professionals specialize in.

“The fact that people are worried about vaccines now shows us how well they work, that these diseases that people used to be terrified of, they have zero idea of what they even are anymore,” Labus said.

Miller said the project will be geared toward those parents who are hesitant and just need a little more information to move forward with confidence, as opposed to those who are resolutely opposed to the idea of vaccines.

On the heels of a measles outbreak in west Texas that has claimed the lives of two children, some pediatricians are reporting more demand for the measles, mumps, and rubella vaccine from parents who had not previously vaccinated their children.

Miller expressed empathy for vaccine-hesitant parents, who she says are opting out because they truly believe they’re making the right choice for their kids.

“I think our biggest challenge will be to really help them understand why vaccination truly is the right choice for their child, not only to protect their own children, but to protect those around them.”