Jessica Kaufman and Margie Danchin write:
The World Health Organisation (WHO) has named vaccine hesitancy as one of their top 10 threats to global health for 2019.
Last week, the wife of an NRL footballer made national headlines after posting on Instagram that the couple did not plan to vaccinate their children.
Indeed, there’s rarely a time vaccination isn’t a hot topic of public debate. What’s important to note is that anyone can use evidence-based communication techniques to be an advocate for vaccination – you don’t need to be an expert in the field.
Conversations between peers can be very influential, because our behaviours are shaped by social norms, or what other people in our network value and do.
Who do we need to talk to?
While the current measles outbreaks in the United States and Europe are concerning, much of the reporting has over-simplified the issue, with sensationalised headlines placing the blame almost solely on “anti-vax” parents.
In reality, the vast majority of people whose children are missing some or all doses of the recommended vaccines are not “anti-vaxxers”, and labelling them as such is unhelpful.
The ability to register for vaccination exemption based on conscientious objection was removed in 2016, but it was last recorded in December 2015 as affecting only 1.34% of eligible children.
Current childhood vaccination coverage in Australia is between 90.75-94.67%, depending on age.
This suggests that missed opportunities and access barriers, such as parents being unable to get to the GP or a council immunisation session, are much more substantial contributors to under-vaccination.
Communication about vaccines is unlikely to impact the behaviour of firm refusers and those facing access barriers. However, communication has enormous influence when it comes to the 43% of parents who have some questions or concerns about vaccines.
Aggressive or dismissive language can make people less likely to vaccinate, while open, respectful discussion with a trusted individual can encourage hesitant parents towards vaccination.
Tips for discussing vaccination
Many people struggle with how to discuss vaccination when confronted with a friend, relative or acquaintance who expresses hesitancy.
Simply providing lots of facts or dismissing their views is not effective.
Instead, these are some tips everyone can use when talking about vaccines, drawing from evidence-based communication techniques. Studies in the United States and Canada have trained healthcare providers to use techniques like these to increase uptake of adolescent HPV vaccination and infant vaccines, and more studies are currently underway.
Ask about, and listen to, people’s concerns: not everyone is driven by the same issues or experiences. Find out what specifically is concerning the person. Is it safety? Effectiveness? Side effects?
Acknowledge their concerns: remember, everyone loves their children. No one is refusing to vaccinate because they want their child to get sick, or because they wilfully hope other children will get sick. Acknowledging that you see where someone is coming from can go a long way in establishing trust.
Provide information to respond to their concerns: share what you know, and try to provide reliable sources for your information. Be careful not to debunk myths too aggressively, as this can actually backfire.
Share personal stories: emotive stories tend to have more impact than facts. This is one reason stories of rare vaccine adverse events can seem to carry more weight than overwhelming safety figures. Share your own stories of positive experiences with vaccines, or better yet, discuss your experience with the diseases they prevent.
Don’t pass judgment: people may discuss vaccination many times with many different people before they decide to vaccinate, especially if they are very hesitant. Your goal should be to establish yourself as a trusted, non-judgmental person with whom they can share their questions and concerns. Berating them won’t convince them to vaccinate, but it will convince them never to speak to you about vaccines again.
These communication tips can help support discussions about vaccines with someone who is hesitant, but open to discussing their position. If, however, you find yourself publicly debating a “vocal vaccine denier”, the WHO has developed a toolkit to help guide your responses.
In such a situation, your intended audience is not the vaccine denier themselves, but the public who may be watching or reading your debate.
The techniques used by a vaccine denier could include referring to conspiracies, fake experts, selective or misrepresented evidence, or impossible expectations (such as 100% safety). The WHO recommends you identify the techniques the denier uses and then correct their content.
If you’re a strong supporter of vaccination, you can become a powerful ally in the effort to sustain high coverage rates in your community. Listen and share your views respectfully, build and maintain open and trusting relationships, and yours may be the words that encourage another person to vaccinate.
• Jessica Kaufman is a postdoctoral researcher at the Murdoch Children’s Research Institute and the Centre for Health Communication and Participation (La Trobe University), and an Honorary Fellow of the University of Melbourne. Her current research projects include designing and testing new interventions to improve uptake and acceptance of maternal and childhood vaccines; vaccine program evaluation; and developing a database of instruments to measure vaccine-related attitudes, knowledge and decision-making.
• Margie Danchin is a general and immunisation paediatrician at the Royal Children’s Hospital and a senior research fellow at The Murdoch Children’s Research Institute. Margie has extensive expertise in vaccine research focused on vaccine clinical trials, vaccine safety and new strategies to enhance the performance of existing vaccines in different settings, particularly rotavirus vaccines. Recent research has focused on understanding parental and provider attitudes, behaviours and concerns regarding vaccines and the development of new, innovative interventions to reduce parental vaccine hesitancy.
• This article was first published by The Conversation