Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Elise Schaller, DNP, MHA, APRN, CPNP-PC


Roxanne Reid, DNP, MSN-Ed, RN

Laura Kuensting, DNP, APRN, PCNS-BC, CPNP, CPEN


Problem: To date, there is a significant gap in the literature involving studies evaluating the time healthcare providers spend educating vaccine-hesitant caregivers about the necessity for their child’s immunizations. Due to alarming resurgence rates of vaccine-preventable diseases in children, this project aimed to answer the following question: In vaccine-hesitant caregivers of newborns through six months of age, what is the effect of provider discussion time on vaccine administration (item) at well-child visits during the child’s first six months of life?

Methods: Using a descriptive observation design, pre-collected data on provider discussion time and vaccine administration was evaluated retrospectively from June 1, 2022, through December 31, 2022. A convenience sample of all newborns entering a Midwest pediatric primary care clinic was included (N = 210).

Results: A total of 64.3% of caregivers said yes to all items at every visit (n = 135) and 35.7% said no to at least one item (n = 75). 119 individual teaching sessions with a total discussion time of 23.3 hours were provided. The results of a two-tailed Mann-Whitney U test assessing for significant differences in the length of discussion time and caregivers saying Yes or No to items at each visit were found to be not statistically significant. However, a strong clinical effect was seen with 50% of caregivers agreeing to a previously refused item after receiving vaccine education, regardless of length.

Implications: While no clear evidence was determined on how provider discussion time may affect a caregiver’s decision to vaccinate their children, the strong clinical effect seen in this project further supports the need for continued research into determining the most effective way to mitigate vaccine hesitancy and improve childhood vaccination rates.