Vaccine confidence

Background

MVEC strongly encourages people to seek answers to their questions, and to be well informed with evidence‑based information. There is a large volume of vaccine information available, particularly on the internet, which can be overwhelming. Some of the information about vaccines is misinformation – there are many conspiracy theories too – which makes it difficult to discern which information sources are trustworthy and hard to know what is true.

Nearly half of all parents have some concerns about immunising their children, ranging from minor concerns to more serious degrees of vaccine hesitancy. Research suggests that information alone is not enough to address people’s concerns about immunisation, even when it comes from recommended sources. Vaccine confidence stems from how vaccines are discussed, as well as the information shared.

Recommendations

One of the most effective strategies to address people’s questions and concerns about vaccines is through a discussion with a trusted healthcare provider like a GP, nurse, paediatrician or midwife. Effective conversations are non-judgemental and help guide people towards accepting vaccination.

Having a combative conversation with a person who has questions about vaccines is never helpful. If possible, try to work out where the person sits on the vaccine hesitancy spectrum. They may have only minor concerns, more serious concerns or they may refuse vaccines all together.

Key steps to an effective vaccine conversation

1. Find out all of the person’s questions and concerns

• Start with an open-ended question, like “What concerns do you have?”
• Try to just listen and not jump in and correct their beliefs straight away.
• Encourage them to share all their concerns before you start responding. They may mention their most important concern last.
• Once they have had a chance to list their concerns, summarise them to check your understanding.

2. Acknowledge concerns and share knowledge

• Not everyone is “vaccine hesitant” – having questions is very normal. People are likely to be more receptive to what you have to say if you acknowledge their concerns without judgement.
• It is helpful to ask if you can share what you know about vaccine safety and effectiveness and provide some good resources and information. Try to keep your explanations clear and check for understanding.
• At this point, it is good to reinforce their motivation to accept vaccination.

3. Discuss disease severity

• It is always good to bring the discussion back to centre on disease severity, rather than focusing exclusively on the vaccines. This reminds people why we are vaccinating and reinforces the benefit.

4. Recommend vaccination

• Lastly, make a clear and strong recommendation to have the vaccine(s). This reinforces the importance of vaccination and clearly shows that you believe this is the best way to protect the person against vaccine preventable diseases.
• If it is possible and the person is willing, deliver the vaccine(s) or explain where they need to go to receive them.

5. Continue the conversation

• If the person is not yet ready to accept vaccination, keep the communication open and invite them back at a later time to continue the conversation.

Some of these strategies can also be used in conversations between friends and family.

The best approach is not to judge people, correct them, but instead to be curious about their concerns. Focus on your shared common interest, which is the health and wellbeing of them and their family.

Tackling misinformation

While it can be tempting to try to correct misinformation whenever you hear it, this can actually give the issue more oxygen. When misinformation is spreading widely and beginning to affect people’s vaccination behaviour, it may be time to step in.

If an individual is spreading misinformation, try to speak with them privately, rather than in a public debate online or in person. Acknowledge the emotion and try to look for the truth together.

When debunking a particular myth, start by clearly restating the truth. Then, explain why the myth is untrue. There are often alternative explanations you can provide for negative experiences that people may have attributed to vaccination.

For example, if someone believes that the flu vaccine gives them the flu because they feel sick after the vaccine, it is not enough to simply tell them that is untrue. Explain why this is untrue: the vaccine contains an inactivated virus that cannot cause the flu. Then follow this with an alternative explanation for the person’s symptoms: this is your body generating an immune response to the vaccine, and these symptoms are much milder and briefer than actual flu symptoms.

Finally, restate the truth. People remember what we say first and last, and what we say more than once. Make sure it is the truth and not the myth that sticks in their minds.

Resources

• For general vaccination concerns
  • NCIRS Sharing Knowledge About Immunisation (SKAI) project
  • The Conversation: Everyone can be effective advocate for vaccination- here’s how
• Addressing misinformation and talking about vaccines in online forums
  • World Health Organization: How to respond to vocal vaccine deniers in public
  • Steffens MS, Dunn, AG, Wiley KE, Leask J. How organisations promoting vaccination respond to misinformation on social media: a qualitative investigation. BMC Public Health. 2019;19(1):1348. doi:10.1186/s12889-019-7659-3
  • UNICEF, First Draft, Yale Institute for Global Health and PGP: Vaccine Misinformation Management Field Guide