Call to improve vaccination communication

VACCINE hesitancy is a greater cause for concern than true vaccination objection, and doctors and scientists alike need to step up their communication strategy to deal with it, says a leading expert.

Professor Paul Van Buynder, public health physician and a director of the Influenza Specialist Group, told MJA InSight that he had “given up on the true vaccination objectors”.

“They are not going to be converted by a discussion about science. They are lost to the vaccination program.

“By trying to convince these people, we’re spending less time talking to those who are worried about vaccinations, and these are the patients who are much more likely to respond to a conversation about the science.”

Professor Van Buynder was commenting on research published today in the MJA which found there was only a small increase in the registered vaccination objection rate between 2002 and 2013. The authors analysed data from the Australian Childhood Immunisation Register for children aged 1–6 years. They wrote that the number of children affected by registered vaccination objection rose from 1.1% in 2002 to 2.0% in 2013. The authors also noted that children with a registered objection were clustered in regional areas, and that the proportion affected by objection was lower among children in areas in the lowest bracket of socio-economic status than in those of highest socio-economic standing.

• Related: MJA -- Trends and patterns in vaccination objection, Australia, 2002–2013
  
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The proportion not affected by recorded objection but who were only partly vaccinated for vaccines due at 2, 4 and 6 months was higher in lower socio-economic areas, which suggested problems of access to health services, missed opportunities and logistic difficulties.

The authors said that GPs should be “on the alert for appropriate catch-up opportunities for partially vaccinated children, as in most cases they are probably not up to date for reasons other than parental objection”.

Lead author of the study, Dr Frank Beard, public health physician at the National Centre for Immunisation and Surveillance, said the research was timely and highlighted that anti-vaccination groups were not having as great an impact as they might think.

“There has been far too much focus on vaccination objection, and we’ve now shown it’s only a relatively small population that make up this group”, he told MJA InSight. “It’s important not to lose sight of the other more significant factors that might reduce rates of vaccination.”

Dr Beard said that improving access to vaccination service providers was essential, as was establishing a national vaccination reminder system.

Professor Van Buynder said that he is noticing “worrying pockets” in the community where vaccination schedules were not being followed.

“There is also a trend of ‘designer schedules’, where parents pick out which vaccinations they will give their child, and skip others.”

Professor Van Buynder said it was vital that the medical and science community become more active and vocal on social media to get the vaccination message across.

“It is frustrating. If people have a leaky pipe, they call a plumber, but if they have a health concern they are more likely to look up mummy blogs online and [read that] the HPV vaccine causes ovarian failure.

“Unfortunately, some people get these gut feelings and they run with them,” he said.

Dr Beard added that it was essential to equip GPs with the resources to manage the problem within the consultation room.

“It is very hard to shift beliefs, but there is a lot of funding now going towards communications strategies,” he said.

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• Related: MJA InSight -- Hal Willaby & Julie Leask: Creating acceptance

Co-author of the study, Associate Professor Julie Leask from the University of Sydney, is at the forefront of developing communications materials for managing vaccine hesitancy.

Professor Van Buynder has also been part of a team that has worked on another project called mdBriefCase Australia, an online resource that provides practical support for GPs on a range of issues, including vaccine hesitancy.

This resource includes a range of case studies that could be applied to real life scenarios.

“We want to provide a learning experiences for GPs, where they can apply targeted messaging – because different situations will require different messages.”

Professor Van Buynder said he understood how time-restricted GPs were, and that they were already dealing with a broad mix of conditions at any one time.

“They can’t be expected to know all that I know about immunisation, for example, which is why it is important that we provide these easy tools that can be used in a short amount of time.”

He said there were some powerful stories of people who were previously against vaccination and had changed their position, and using these examples in public awareness campaigns could help counteract misinformation.

Last week, first-time mother Cormit Avital shared an online video where she revealed she regretted her decision not to be vaccinated for whooping cough after she passed the disease to her child.

“We need to use these sorts of stories to get the message across,” Professor Van Buynder said.