Tag: vaccine hesitant

Immunization Education Agreement

Having disagreements about getting kids vaccinated and protected are not rare these days.

“Many parents have questions about their children’s vaccines, and answering their questions can help parents feel confident in choosing to immunize their child according to the CDC’s recommended immunization schedule.”

CDC on Talking to Parents about Vaccines

They never were though.

The anti-vaccine movement, concerns about the pain from the shots, and worry about side effects have been around for as long as there have been vaccines.

Options When You Disagree About Vaccines

So what should you do if you disagree with someone about vaccines and you don’t want to get your child vaccinated?

It depends on who it is.

For example, if the person you disagree with is your pediatrician, then simply arguing about it likely isn’t a good idea, on either side.

Most pediatricians understand that many vaccine-hesitant parents are simply scared because of things they read and see on the Internet and they want to help you get educated, see through the myths and misinformation that are out there, and eventually get caught up and vaccinated.

They understand that terminating the physician-patient relationship over vaccines truly is a last resort for “when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists.”

Immunization Education Agreement

So what can you do besides arguing?

Will you agree to get educated about vaccines?
Will you agree to get educated about vaccines using recommended and reliable sources of information?

Pediatricians and other health care providers can agree to get better educated about all of the different ways to talk to vaccine-hesitant parents.

And vaccine-hesitant parents can agree to get educated about vaccines and vaccine-preventable diseases using books and websites that are recommended by their provider.

Reassure your pediatrician that you are not done talking about vaccines and agree to get educated about vaccines:

Immunization Education Agreement Form

Even if you think that you have already done enough research, do just a little more. And then talk to you pediatrician again. And again if you have to.

Vaccines are safe. Vaccines are necessary. Don’t let anyone scare you into thinking that they aren’t.

What to Know About the Immunization Agreement

Whether you find yourself on opposite sides about immunizations with a friend, your spouse, an ex, or your pediatrician, agree to get educated about vaccines using these recommended and reliable sources of information and then talk about it some more.

More on the Immunization Education Agreement

We Don’t Know How To Talk About Vaccines

There is a dirty little secret about vaccines that people don’t seem to like to talk about.

No, it’s not about toxins or autism.

“Our systematic review did not reveal any convincing evidence on effective interventions to address parental vaccine hesitancy and refusal. We found a large number of studies that evaluated interventions for increasing immunization coverage rates such as the use of reminder/recall systems, parent, community-wide, and provider-based education and incentives as well as the effect of government and school immunization policies.

However, very few intervention studies measured outcomes linked to vaccine refusal such as vaccination rates in refusing parents, intent to vaccinate, or change in attitudes toward vaccines.

Most of the studies included in the analysis were observational studies that were either under-powered or provided indirect evidence.”

Sadaf et al on A systematic review of interventions for reducing parental vaccine refusal and vaccine hesitancy

It’s that we don’t really know how to talk about vaccines to vaccine hesitant parents, at least not in a way that we know will consistently get them to vaccinate and protect their kids.

Understanding Studies About Vaccine Hesitancy

Sure, a lot of studies have been done about talking to vaccine hesitant parents.

We have all seen the headlines:

  • Study: You Can’t Change an Anti-Vaxxer’s Mind
  • Pro-vaccine messages can boost belief in MMR myths, study shows
  • UWA study shows attacking alternative medicines is not the answer to get parents to vaccinate kids
  • Training Doctors To Talk About Vaccines Fails To Sway Parents

Does that mean that you shouldn’t try to talk to vaccine hesitant parents?

Of course not.

“How providers initiate and pursue vaccine recommendations is associated with parental vaccine acceptance.”

Opel et al on The Architecture of Provider-Parent Vaccine Discussions at Health Supervision Visits

Just understand that these headlines are usually about small studies, which if they were about treating a child with asthma or strep throat,  likely wouldn’t change how you do things.

Why do anti-vaccine websites still post misinformation about fake recommendations to stop breastfeeding?
Why do people continue to believe misinformation about fake recommendations to stop breastfeeding?

In one study that concluded that “physician-targeted communication intervention did not reduce maternal vaccine hesitancy or improve physician self-efficacy,” the physicians got a total of 45 minutes of training!

So they shouldn’t have so much influence about how you might talk to parents about vaccines that you throw up your hands at the thought of talking to a vaccine hesitant parent and won’t even think about learning how to use the CASE method, why presumptive language might work, or about vaccination-focused motivational interviewing techniques.

The bottom line is that no matter what the headlines say, we just haven’t found the best way to talk to vaccine-hesitant parents and help them overcome their cognitive biases. And until more studies are done, none of the existing studies about anti-vaccine myth-busting should likely overly influence how you do things.

“Physicians should aim for both parental satisfaction and a positive decision to vaccinate. Researchers must continue to develop conceptually clear, evidence-informed, and practically implementable approaches to parental vaccine hesitancy, and agencies need to commit to supporting the evidence base. Billions of dollars fund the research and development of vaccines to ensure their efficacy and safety. There needs to be a proportional commitment to the “R&D” of vaccine acceptance because vaccines are only effective if people willingly take them up.”

Leask et al on Physician Communication With Vaccine-Hesitant Parents: The Start, Not the End, of the Story

If you spend any time talking to vaccine hesitant parents, especially those who are on the fence, you quickly learn that many are eager to get good information about vaccines and all want to do what is best for their kids.

It’s just hard for many of them to do what is best when their decisions are getting influenced by vaccine scare videos and many of the 100s of myths about vaccines that are out there.

“…while the drivers of vaccine hesitancy are well documented, effective intervention strategies for addressing the issue are sorely lacking. Here, we argue that this may be because existing strategies have been guided more by intuition than by insights from psychology and by the erroneous assumption that humans act rationally.”

Rossen et al on Going with the Grain of Cognition: Applying Insights from Psychology to Build Support for Childhood Vaccination

So while we need more studies on the best ways to talk to vaccine hesitant parents, don’t dismiss all of the ways that might be effective, such as:

It is also important to become familiar with the myths and anti-vaccine talking points that may be scaring your patients away from getting vaccinated on time.

Why is this important?

If a parent is concerned about glyphosate, you might not sound too convincing telling them not to worry if you don’t even know what glyphosate is.

What to Know About Vaccine Hesitancy Studies

While we learn better ways to talk about vaccines, so that vaccine-hesitant parents can more easily understand that vaccines are safe and necessary, don’t dismiss current strategies because of small studies and attention grabbing headlines.

More on Vaccine Hesitancy Studies

 

Who’s Who in the Anti-Vaccine Movement

No, this isn’t another article about Andy Wakefield or Jenny McCarthy.

Defining the Anti-Vaccine Movement

The great majority of people know that vaccine work and that they are safe and necessary.

And then there are the folks who don’t.

“The term movement as a description for vaccine deniers is also very misleading. A movement implies the image of a powerful, coordinated group, united by a shared collective identity.”

WHO on How to respond to vocal vaccine deniers in public

It is important to understand that this minority of people who do not believe in vaccines do not have uniform beliefs. Calling them a movement is simply for convenience, as a way to group them all together.

Who’s Who in the Anti-Vaccine Movement

So who are the different types of people that you might come across in various discussions about vaccines?

More importantly, why do you want to know?

You don’t want to think that everyone who questions the safety or efficacy of vaccines is totally anti-vaccine and is going to refuse some or all vaccines. Some of these parents really do just have questions, want to get educated, and may have just been scared by misinformation. On the other hand, others won’t change their minds no matter what new evidence you bring to the table or how long you talk.

“Although many may characterize all individuals who eschew vaccines as “anti-vaccine” or “vaccine deniers,” in reality there is a broad spectrum of individuals who choose not to have themselves or their children vaccinated.”

Tara C Smith on Vaccine Rejection and Hesitancy: A Review and Call to Action

However you characterize the groups, you will be much less frustrated when talking about vaccines if can quickly recognize if you are talking to someone who is:

  • a go along to get along immunization acceptor – this type of cautious acceptor understands and accepts that vaccines work and that they are safe and necessary, but still may have some doubts about one or more vaccines.
  • an immunization advocate – understands, accepts, and helps teach others that vaccines work and that they are safe and necessary.
  • a vaccine denier – someone who does not accept the process of vaccination while denying scientific evidence and employing rhetorical arguments to give the false appearance of legitimate debate. These are the vaccine rejectors who are “unyieldingly entrenched in their refusal to consider vaccine information.”
  • vaccine hesitant – usually a classic fence-sitter, who has doubts about whether vaccines are really safe or necessary or has simply been scared and influenced about something they read on the Internet. They may skip or delay some vaccines, but are typically willing to listen to why getting their child fully vaccinated is their best and safest option.
  • a vaccine refuser – doesn’t vaccinate their kids or themselves, but unlike the vaccine denier, probably doesn’t have very strong beliefs in conspiracy theories and may be willing to listen if you address their concerns about vaccines. They are also sometimes called the vaccine resistant. Often seem to put aside their beliefs against vaccines in special circumstances, like during outbreaks or other high risk situations.
  • a vaccine skeptic – this term is often misused, as classically, a vaccine skeptic would be defined as a person who has questions about vaccines, but then accepts that they are safe and necessary once they have examined all of the evidence. As a skeptic, they would also question all of the “science” of the anti-vaccine movement too, and would find it lacking. Folks who question vaccines, but then ignore all of the evidence that supports their safety and effectiveness are in denial – they are not vaccine skeptics.
  • a vocal vaccine denier – a vaccine denier who influences others, especially on the Internet.
  • one of the worrieds – often immunization acceptors who are still a little worried about vaccine side effects.

What about those who say that they are pro-safe vaccines or pro-choice about vaccines?

Don’t be fooled, these are simply anti-vaccine arguments of a vaccine denier or refuser.

Jenny McCarthy and Jim Carrey went on a mission to Green Our Vaccines in 2008.
Jenny McCarthy and Jim Carrey went on a mission to Green Our Vaccines in 2008. How would you classify them?

Still having trouble telling the groups apart?

Try asking the person you are talking to what would change their mind about vaccines.

Would new evidence work? Or would they dismiss any new evidence as being biased, just as they already dismiss all of the evidence that  so strongly supports that vaccines are safe and necessary?

It is important to identify who’s who, because while you will likely not change the mind of someone who is at the stage of being a vaccine denier, you have a much better chance to help the others get their kids vaccinated and protected.

What to Know About Defining the Anti-Vaccine Movement

The anti-vaccine movement includes a lot of different groups of people, from those who are simply hesitant because a friend or family member is scaring them on Facebook to the vocal vaccine denier, who probably wouldn’t even change their mind if they were bitten by a rabid dog.

More About Defining the Anti-Vaccine Movement