Class 18: Vaccine hesitancy

Vaccine hesitancy

The reluctance or refusal to vaccinate despite the availability of vaccines

Why do outbreaks still occur?

Complacency, Convenience, and Confidence

Complacency

Perceived risks of vaccine-preventable diseases; vaccination is not deemed a necessary prevention action. Other life/health responsibilities seen as more important at that point in time.

Conveinence

Extent to which physical availability, affordability, willingness-to-pay, geographical accessibility, ability to understand (language and health literacy) and appeal of immunization services

Confidence

trust in vaccines, in the system that delivers them, and in the policy makers who decide which vaccines are needed and when.

Top 10 Global Health Threats 

1. Air pollution and climate change

2. Noncommunicable Diseases

3. Global influenza pandemic

4. Fragile and vulnerable settings

5. Antimicrobial Resistance

6. Ebola and other high-threat pathogens

7. Weak primary health care

8. Vaccine hesitancy

9. Dengue

10. HIV

Factors of vaccine hesitancy

• Misinformation

• Perception of low vaccine efficacy or importance

• Distrust with institutions/health system

• Religious, cultural or political reasons

• Concerns with safety or side effects

• Agency and autonomy

Parents’ Vaccine Refusal (E.g., MMR)

• Fear/mistrust

• Lack of understanding

• Peer pressure/sociocultural beliefs

• Conflicting/unreliable information (UK Wakefield Studies)

• Social media/celebrity influencers (Jenny McCarthy)

What is being done to address this?

• International Level: WHO

• National Level: Reports from the Chief Public Health officer Dr. Theresa Tam, PHAC

  • Vaccine Hesitancy in Canadian Parents

  • Realizing the Future of Vaccination for Public Health

• Provincial Level:

  • News releases from Community Health and Services

  • Memo from MOH Dr. Fitzgerald to all physicians/NPs

Vaccine Hesitancy: Best practices

1. Identify target audience and establish trust

2. Provide info on both risks and benefits

3. Give facts then address myths

4. Use visual aids

5. Test communication prior to launching

How can CHNs help?

• Understand the concern of the parent

• Use clear language to present evidence of vaccine benefits and risks fairly and accurately

• Inform parents about the rigor of the vaccine safety system

• Address the issues of pain with immunization

• Do not dismiss children from your follow-up because parents refuse to immunize

Checklist for finding credible information on the internet

• Is it clear who owns the website?

• Does the website clearly state its purpose?

• Is the information based on sound scientific study?

• Does the information on the website make sense?

• Does the website weigh evidence and describe the limits of research?

• Is the website filled with “junk science” or conspiracy theory?

• Are the people or groups online qualified to address the subject?

• What is the privacy policy of the website?

• Does the website direct you to additional information?

What can nurses do to address vaccine hesitancy before a visit?

• Stay up-to-date with current vaccination recommendations

• Trained (for multiple vaccinations per visit)

• Vaccines ordered/available

• Use client reminder systems

  • Educate yourself! Professional responsibility

What can nurses do to address vaccine hesitancy during a visit?

• Implement standing orders: assess and administer recommended vaccines

• Encourage clients to seeks vaccines that are due or overdue

• Educate on why recommended vaccine is good for client (e.g., age, health status, lifestyle, occupation)

• After-visit summary, schedule of recommended vaccines, other education

  • Educate re: normal side effects

What can nurses do to address vaccine hesitancy after a visit?

• Document (keep client records up-to-date)

  • Paper, EMR, personal booklet/record

• Update them on what’s next (e.g., follow-up assessment, next dose in series)

  • Phone, messaging system – reminders

  • Educate! Advocate for vaccine uptake!