Montgomery County, Ohio, has experienced a significant decline in vaccination rates for routine childhood immunizations in recent years. For example, in the 2024-2025 school year, the percentage of students entering kindergarten in Montgomery County with all required vaccines was 82%. As expected, the number of vaccine-preventable diseases has also been increasing as routine vaccination rates have declined. In 2024, measles was diagnosed in a Montgomery County resident for the first time in the last 20 years. This case expanded to a regional measles outbreak in Southwest Ohio.
To address declining vaccination rates, Public Health – Dayton & Montgomery County partnered with Dayton Children’s Hospital to survey school superintendents and nurses about perceived barriers to vaccination for children in their districts. Four out of five surveyed respondents cited beliefs by families that vaccines are not safe or effective for children. Specifically, spillover from COVID vaccine misinformation decreased trust in all vaccines, including routine childhood vaccines required for school; families are using Ohio’s liberal exemption policies to sign waivers for required school vaccinations. Additional cited logistical challenges included transportation, cost, and language barriers.
As a result of our surveys of school personnel, Public Health created a website, http://www.vaccinesprotectkids.org/, which includes information on the benefits of vaccines, which vaccines are needed for school, vaccine safety information, how to get help paying for vaccines (translated into 30 languages), and where families can go to receive childhood vaccinations. Information about Vaccines for Children and guidance on finding Reliable Sources for Vaccine Information were shared with school leadership throughout Montgomery County for leaders to provide to families of students in their districts. A limited media campaign consisted of social media ads aimed at families of school-aged children which linked back to the landing page of the campaign, http://www.vaccinesprotectkids.org, for further information.
We realized the need for a more robust integrated multi-media advertising campaign to normalize scheduling and receiving childhood vaccines as a routine part of helping children stay healthy, so they can grow, learn, and thrive, while emphasizing that these vaccines have a long track record of safety and effectiveness. Simply put, vaccines protect kids so kids can be active in learning and life. The campaign implementation was planned for back-to-school time, with a goal of increasing the rate of routine childhood vaccination in Montgomery County students, as measured by data schools are required to submit to the Ohio Department of Health each October.
The missing piece prior to full implementation of our broader multi-media campaign was to learn which messaging would be most effective with our priority population- parents of school-aged children. We created a parent survey to test two different ad campaigns to learn which messaging best inspires parents to want to learn more and encourages parents to get their children vaccinated. The first ad set was directly themed to back-to-school planning- getting needed vaccines is as important as getting needed school supplies when planning for a successful school year. The second ad set was sports-themed, with the slogan “vaccines help keep kids in the game.” To test these ad sets, we surveyed parents at WIC clinics, health promotion events for parents, and libraries using QR accessible A/B testing. Parents overwhelmingly preferred the back-to-school themed messaging by a ratio of about 7:1. Parents provided feedback that the back-to-school images were more generalizable to families whose children may not participate in sports, more directly vaccine focused, and found the messaging in the preferred ads to be effective - speaking to parents (91%), encouraging parents to vaccinate their children (94%), and inspiring parents to want to learn more (93%). Suggestions were made to provide the messaging in Spanish as well.
As a result of the family surveys, Public Health has improved its capacity to create meaningful communications products that resonate with the intended audience. With the endorsement of our back-to-school themed messaging by student families, we are planning for full implementation of our multimedia campaign during late summer and early fall to promote routine childhood vaccines as a standard part of a healthy childhood.
Becky J. Thomas MD, MPH, CHES , Medical Director Public Health – Dayton & Montgomery County; Dan Suffoletto, Public Information Officer Public Health – Dayton & Montgomery County
