Background: Although healthcare providers (HCPs) are the most trusted source of vaccine information, there is a paucity of easily accessible, multidisciplinary educational tools on vaccine communication for them. Virtual simulation games (VSGs) are innovative yet accessible and effective tools in healthcare education. The objectives of our study were to develop VSGs to increase HCP confidence and self-efficacy in vaccine communication, advocacy, and promotion, and evaluate the VSGs’ effectiveness using a pre-post self-assessment pilot study. Methods: A multidisciplinary team of experts in medicine, nursing, pharmacy, and simulation development created three VSGs for HCP learners focused on addressing conversations with vaccine hesitant individuals. We evaluated the VSGs with 24 nursing students, 30 pharmacy students, and 18 medical residents who completed surveys and 6-point Likert scale pre-post self-assessments to measure changes in their confidence and self-efficacy. Results: There were no significant differences in baseline confidence and self-efficacy across the three HCP disciplines, despite varied levels of education. Post-VSG confidence and self-efficacy (median: 5) were significantly higher than pre-VSG (median: 4–5) for all three HCP disciplines (P ≤ 0.0005), highlighting the effectiveness of the VSGs. Medical residents reported significantly lower post-VSG confidence and self-efficacy than nursing and pharmacy learners despite completing the most significant amount of education. Conclusions: Following the completion of the VSGs, learners in medicine, nursing, and pharmacy showed significant improvement in their self-assessed confidence and self-efficacy in holding vaccine conversations. The VSGs as an educational tool, in combination with existing clinical immunization training, can be used to increase HCP confidence and engagement in vaccine discussions with patients, which may ultimately lead to increased vaccine confidence among patients.

Background: Measurement of SARS-CoV-2 antibody seropositivity is important to accurately understand exposure to infection and/or vaccination in specific populations. This study aimed to estimate the serologic response to SARS-CoV-2 virus infection and vaccination in children in Calgary, Alberta over a two-year period. Methods: Children with or without prior SARS-CoV-2 infections, were enrolled in Calgary, Canada in 2020. Venous blood was sampled 4 times from July 2020 to April 2022 for SARS-CoV-2 nucleocapsid and spike antibodies. Demographic and clinical information was obtained including SARS-CoV-2 testing results and vaccination records. Results: 1035 children were enrolled and 88.9% completed all 4 visits; median age 9 years (IQR: 5,13); 519 (50.1%) female; and 815 (78.7%) Caucasian. Before enrolment, 118 (11.4%) had confirmed or probable SARS-CoV-2. By April 2022, 39.5% of previously uninfected participants had a SARS-CoV-2 infection. Nucleocapsid antibody seropositivity declined to 16.4% of all infected children after more than 200 days post diagnosis. Spike antibodies remained elevated in 93.6% of unvaccinated infected children after more than 200 days post diagnosis. By April 2022, 408 (95.6%) children 12 years and older had received 2 or more vaccine doses, and 241 (61.6%) 5 to 11 year-old children had received 2 vaccine doses. At that time, all 685 vaccinated children had spike antibodies, compared with 94/176 (53.4%) of unvaccinated children. Conclusions: In our population, after the first peak of Omicron variant infections and introduction of COVID-19 vaccines for children, all vaccinated children, but just over one-half of unvaccinated children, had SARS-CoV-2 spike antibodies indicating infection and/or vaccination, highlighting the benefit of vaccination. It is not yet known whether a high proportion of seropositivity at the present time predicts sustained population-level protection against future SARS-CoV-2 transmission, infection or severe COVID-19 outcomes in children.

Background: Vaccine hesitancy is a significant threat to public health. Healthcare providers (HCPs) can address hesitancy during routine patient conversations; however, few multidisciplinary education tools exist for HCPs to learn to engage in vaccine discussion especially considering new vaccine technologies such as mRNA vaccines. The objectives of this study were to explore HCP learners’ experiences with COVID-19 vaccine communication, and qualitatively evaluate an online learning module composed of virtual simulation games (VSGs) which utilize the PrOTCT Framework for HCP vaccine communication.Methods: Three virtual focus groups were conducted from December 2022 to January 2023 with Canadian healthcare learners in nursing (N = 6), pharmacy (N = 9), and medicine (N = 7) who participated in a larger study measuring the effectiveness of the VSGs. Using a pragmatic approach, a qualitative thematic analysis was conducted using NVivo to identify themes and subthemes.Results: A total of 22 HCP learners participated in this study and three key themes were identified. Across all three disciplines, participants expressed that (1) their prior education lacked training on how to hold vaccine conversations, resulting in uncomfortable personal experiences with patients; (2) the VSGs increased their confidence in holding vaccine conversations by providing novel tools and skills; and (3) participants also provided feedback to improve the VSGs which was implemented and supported the dissemination to all HCP professions.Conclusion: Although HCPs are a trusted source of vaccine information, participants in this study felt they received little training on how to engage in challenging conversations regarding COVID-19 vaccines. The introduction of the PrOTCT Framework and presumptive statements provided novel strategies for HCP to initiate vaccine conversations, especially considering new vaccine technologies and participants appreciated the emphasis on coping strategies and resilience. It is essential that HCP are provided both opportunities to practice managing these conversations, and tools and skills to succeed at an early point in their careers to prepare them for future roles in vaccine advocacy, delivery, and promotion.

Background/Objectives: As the newcomer population in Canada continues to grow, we aimed to collaborate with newcomer families arriving in an urban center in Alberta, Canada to identify strategies to overcome identified barriers newcomers face in obtaining routine childhood vaccines (RCVs). Methods: We recruited newcomers living in Calgary, Alberta to participate in a workshop utilizing the Nominal Group Technique (NGT) to develop solutions addressing barriers to obtaining RCVs. Ranking exercises helped identify the top-proposed interventions based on perceived impact and feasibility for implementation. Based on the identified need for translated vaccine resources, infographics on school-based vaccines were developed. The infographics were pilot-tested in a first-language focus group before the final product was translated into 10 different languages. Results: Consensus from 15 NGT workshop participants identified five key solutions to facilitate obtaining routine childhood immunizations: (1) Increasing access to reliable vaccine information; (2) Ensuring vaccine information and healthcare services are available in different languages; (3) Increasing vaccine appointment availability and optimizing the booking system for ease of navigation; (4) Increasing the role of family doctors in vaccine counseling and administration; (5) Streamlining vaccine record tracking. We developed infographics on the vaccines children in Alberta can receive through school-based vaccine programs and these were pilot-tested with 16 participants in a first-language (Arabic) focus group. Conclusions: The collaborative and iterative process of solution development with newcomers provided a platform for knowledge translation through the development of educational resources on school-based vaccines, addressing the information barrier that newcomers identified when accessing RCVs.

Background Measurement of SARS-CoV-2 antibody seropositivity is important to accurately understand exposure to infection and/or vaccination in specific populations. Methods Children with or without prior SARS-CoV-2 infections, was enrolled in Calgary, Canada in 2020. Venous blood was sampled 4 times from July 2020 to April 2022 for SARS-CoV-2 nucleocapsid and spike antibodies. Demographic and clinical information was obtained including SARS-CoV-2 testing results and vaccination records. Results 1035 children were enrolled and 88.9% completed all 4 visits; median age 9 years (IQR: 5,13); 519 (50.1%) female; and 815 (78.7%) Caucasian. Before enrollment, 118 (11.4%) had confirmed or probable SARS-CoV-2. By April 2022, 39.5% of previously uninfected participants had a SARS-CoV-2 infection. Nucleocapsid antibody seropositivity declined to 16.4% after more than 200 days after diagnosis. Spike antibodies remained elevated in 93.6% of unvaccinated children after more than 200 days after diagnosis. By April 2022, 408 (95.6%) children 12 years and older had received 2 or more vaccine doses, and 241 (61.6%) 5 to 11 year-old children had received 2 vaccine doses. At that time, all 685 vaccinated children had spike antibodies, compared with 94/176 (53.4%) of unvaccinated children. Conclusions In our population, after the first peak of Omicron variant infections and introduction of COVID-19 vaccines for children, all vaccinated children had SARS-CoV-2 spike antibodies, in contrast to 53.4% of unvaccinated children. It is not yet known whether a high level of seropositivity at a point in time indicates sustained population-level protection against SARS-CoV-2 transmission or severe COVID-19 outcomes in children. Summary By April 2022, all vaccinated children with or without acquired SARS-CoV-2 infections had spike antibodies, compared with just over one-half of unvaccinated children. It’s not known whether overall seropositivity level in a population indicates sustained protection against severe COVID-19 outcomes.