“The Hub” at Pitt Trains Health Professions Students to Vaccinate Children

A seven-year-old patient was inconsolable about needing a shot to be immunized against COVID-19. To soothe her distress, Trish Klatt, PharmD, the clinical director and an immunizer at the University of Pittsburgh (Pitt) Vaccination and Health Connection Hub (“the Hub”), sat down and talked to her.

In an attempt to take her mind off the shot, Klatt asked the young patient where she was going afterward. She responded that her mother was taking her out for bubble tea. When Klatt asked if she could join them, the little girl found this very funny.

Klatt ran with it.

“If you let me give you this vaccine, I’ll give you some money and my order, and you can pick up a bubble tea for me, too,” Klatt told her.

Wanting to accept the mission, the patient finally collected herself and sat still for her vaccination.

A short time later, the little girl and her mother came back with Klatt’s beverage. The little girl was all smiles. She teased Klatt and said there hadn’t been any change from the money Klatt had given her. Finally, she told her mother that she hoped they would go back to the Hub for all her vaccinations.

In health care training, the vast majority of students’ experience with children is in a hospital setting where the patients are very sick. Part vaccine clinic and part interprofessional learning space, the Hub brings together Pitt students from all health professions to gain experience working with healthy children and adults.

“They’ve had very little experience interacting with well children in a health care setting,” Klatt said. “They need to learn about interpersonal communication and engaging both the parents or caregivers and the children. It’s a very different dynamic than in an acute care setting.”

At the Hub, while administering COVID-19 and flu vaccines to children 3 to 17 years old, health professions students learn three basic tenets of working with this population: speak directly to the child; empower the child with free choice; and never lie.

“Many health professionals tend to talk only to the parents while the child is just sitting there getting more and more anxious,” Klatt said. “You have to talk directly to the child. They are the patient.”

The Hub offers what Klatt describes as a “buffet” of ways to empower children with free choice. From the moment they enter the clinical area, they have options. Children can choose to wear a costume cape or not while they receive the vaccine. They can opt to wear an animal mask. They can pick the Band-Aid decoration they’d like or opt out of using a bandage. They can sit any place in the room that they choose—whether it’s in front of the TV where the children’s show PAW Patrol loops; in a private, outer-space–themed nook; or next to the table covered with Matchbox toy cars.

Young patients also devise their own “poke plan,” in which they decide whether to sit on their caregiver’s lap or independently on the chair; to squeeze a stress ball or hold their caregiver’s hand; to have the immunizer talk them through the process or work quietly without a step-by-step commentary; and listen to the immunizer count down or not to hear the timing of the injection said aloud.

“We are clear from the beginning that they don’t have a choice about getting the vaccine, but we give them as many choices as we can about how we’re going to do it so it’s not as scary or as painful,” Klatt said.

Once the patient is ready to receive the vaccine, providers are honest about how it might feel. They let the child know that it could hurt or pinch a little. This approach, Klatt believes, will pave the way for children to trust their providers and the vaccine process for years to come.

“Be transparent, be vulnerable, and capitalize on every opportunity to connect,” Klatt said. “You quickly gain kids’ trust and respect when you are honest.”

—Sonya Collins
April 2023

Resources to help Educate Your Health Care Team on COVID-19 vaccines and Tailor Your Outreach to specific populations are available at APhA’s Vaccine Confident microsite.