Understanding hesitancy over child vaccinations
Talking to health-care provider can reduce parents’ fears, study finds
One mother from British Columbia was so worried about getting her baby vaccinated that she was wracked with nightmares. She eventually had her child immunized, and new research underscores that health-care providers can play a role in helping to reduce vaccine hesitancy by listening to parent’s concerns.
Although the majority of Canadians have their children immunized, there is growing concern about so-called vaccine hesitancy among parents. A 2013 National Coverage Immunization survey highlighted concerns about vaccines, even among parents who agreed they are safe and effective. Ninety-five per cent of parents who responded to the survey agreed vaccines are safe, 97 per cent agreed they are effective and about 97 per cent agreed they are important for children’s health.
Yet, almost 70 per cent of parents surveyed said they were concerned about potential side effects and about 37 per cent agreed with the false statement that vaccines can cause the same disease they are meant to prevent. Just over 17 per cent agreed with the incorrect statement that alternative treatments can replace vaccines.
Public health officials watch results like that closely.
“Identifying the reasons why Canadians accept or refuse vaccines is essential to learning how to develop, evaluate and promote effective strategies for immunization,” said a Public Health Agency of Canada spokeswoman.
That is also why understanding reasons for hesitancy is one focus of the Canadian Immunization Conference being held in Ottawa this week.
Three co-authors and Devon Greyson, a post-doctoral fellow at the University of British Columbia, conducted interviews to better understand what causes changes in mothers’ attitudes about vaccinations over time. Their research will be presented at the immunization conference.
The researchers interviewed 23 mothers. Nine had become less vaccine hesitant over time — meaning more open to having their children vaccinated. Nine of the mothers had become more hesitant about vaccines and five experienced multiple changes in their attitudes toward vaccines since their children were born.
One mother, said Greyson, described the nightmares she had as she struggled to make a decision about vaccinating her newborn. “There is a lot of pressure on parents these days, especially new parents and especially mothers,” she said. Greyson said her research countered a general belief that vaccine hesitant parents are anti-science. “This is not what we heard.”
Some of the parents interviewed were nervous and not getting the feedback from health providers.
“What we are hearing is that parents value the input of their health-care providers.” She said that parents who are hesitant about vaccines often “come on board” when they are engaged and treated with respect and trust by health-care providers.
On the other hand, she and the other researchers found some parents stopped vaccinating their children after “something happened” such as their child developing a fever after a vaccine or later developing a chronic illness. Some of those parents said they were not satisfied with the follow-up they received to concerns from health providers. “They were not getting the information and support they needed.”
Having a “trust relationship” with a health provider is important, Greyson said. She added that some of the parents interviewed tried to hide their previous opposition to vaccines after changing their views, because of the negative feedback they had received. Other said they grew to understand that they had a “civic responsibility” to vaccinate their children to protect others who could not be vaccinated.
Another Canadian study on vaccine hesitancy released this week warned there is no “magic bullet” to address it because causes are so complex. The study, published in Canada Communicable Disease Report, did point to the key role of health-care providers. The study noted that health-care providers are considered parents’ “most trusted sources of information and advice about vaccination. Health care providers’ recommendations are a major driver of vaccine acceptance.”
The research, led by Ève Dubé of Laval University, proposed health providers build rapport and establish an open dialogue with vaccine hesitant patients. But it recommended avoiding debates with patients who are vaccine refusers, saying adversarial approaches to anti-vaccination activists can “enliven the battle and contribute to a false sense that vaccination is a highly contested topic.”
More research is needed, the paper recommended, to better understand which interventions are most effective in achieving high vaccine coverage.