Coppoc One Health conference highlights vaccine acceptance in 2021


Friday, November 19, 2021

As COVID-19 vaccine issues continue to grab headlines, the Coppoc One Health 2021 conference shed some light on the topic to more than 80 attendees who watched a virtual presentation by Dr. Noni MacDonald, Professor of Pediatrics and Former Dean of Medicine at Dalhousie University and IWK Health Center in Halifax, Nova Scotia. An infectious disease specialist and vaccinologist, Dr. MacDonald is a passionate advocate for global health and the first woman in Canada to become dean of medicine.

Hosted by Purdue University College of Veterinary Medicine, the annual Coppoc One Health on-campus conference, free and open to the public, focuses on the symbiotic relationship between veterinary and human medicine and its global impact. In her November 4 speech, Dr. MacDonald described how vaccine reluctance in routine and COVID-19 vaccinations is a growing problem that will need to be addressed over the next decade and beyond. She said a host of factors influence vaccine hesitancy rates in various ways and in various settings. A closer look at these contexts and factors can provide insight into how the problem can be approached in a personalized approach.

Dr. MacDonald emphasized that using evidence to develop strategies to overcome vaccine reluctance is the way forward towards a future of high vaccine acceptance. Strategies to emphasize include addressing subgroups, using the influence of health workers, using effective discussion skills, dealing with pain and fear, facilitating access to vaccines, manage misinformation and talk to peers.

The following summary recaps several of the issues addressed by Dr. MacDonald.

Reluctance to vaccination

Vaccine hesitation is the delayed acceptance or rejection of vaccines despite their availability. The rates and severity of reluctance vary widely and are influenced by a number of factors. Reluctance exists on a spectrum from complete acceptance to complete refusal. Not all people who choose to be vaccinated do so without asking questions or worrying. In high-income countries, about 10-20% of the population should be reluctant to some or all of the vaccines. Meanwhile, only 1-2% will be truly anti-vaccination and fall on the full spectrum refusal side. These hesitation rates vary depending on the time, location and vaccine.

In response to vaccine reluctance and the challenges presented by COVID-19, the World Health Organization and the World Health Assembly have approved the 2030 Immunization Agenda. This strategic plan for equity program emphasizes the importance of leaving no one behind in spreading the benefits of vaccines around the world. . Over the next decade, this plan will be implemented to increase access to vaccines globally and reduce vaccine reluctance through people-centered, country-owned, based strategies. partnerships and data-driven.

“Even before COVID, the World Health Organization declared vaccine reluctance to be one of the ten threats to global health. It’s a big deal, ”said Dr. MacDonald.

Contextual factors

One thing that needs to be addressed in any attempt to reduce vaccine reluctance is that the individual decision on whether or not to get vaccinated is complex and context-specific. People also have certain tendencies and instincts when it comes to information that can either be damaging or be used to benefit vaccine uptake programs. First, people pay more attention to negative information than positive information. People also tend to rely on anecdotal evidence rather than empirical data. When people hear the story of someone they know who has had a bad experience with a vaccine, it stays in their memory. This impact is not easily squashed with spreadsheets and statistics.

The factors that contribute to reluctance have been broken down and categorized in several ways. As Dr. MacDonald said, “There have been a number of models that have been developed to talk about the many, many, many factors that influence your decision to get vaccinated. “A model, known as”Five CSuggests that the main obstacles to vaccine acceptance are:

  1. Complacency
    When the perceived risk is low and other priorities are set higher, people are less likely to take action to get the vaccine.
  2. Confidence
    People need to feel they can trust the vaccine, its delivery, and the decision-makers who need it.
  3. Constraints
    Structural: low availability or high costs can be a major obstacle to vaccination.
    Psychological: Attractiveness, acceptance, social norms and other internal psychological factors have a great effect on reluctance.
  4. Calculation
    The time a person spends gathering in-depth information can determine their acceptance of a vaccine.
  5. Collective response
    The willingness to protect others goes a long way in building uptake of vaccines. People who want to protect those around them are much more likely to get the vaccine than those who only care about themselves.

Dr MacDonald also said that beyond the Five Cs model, other factors that influence vaccine reluctance include politics and health care workers. She noted that when health workers themselves are vaccinated and recommend vaccinations, their patients are much more likely to be vaccinated as well.

Evidence-based strategies

Dr MacDonald said that with such a wide range of influences and varying degrees of reluctance to immunize, it is important to examine evidence-based and efficacy-based reluctance strategies. Many of these strategies exist with a great deal of research to support the techniques.

Detect and address subgroups with low absorption

Some groups of people will be more or less receptive to certain vaccines for many of the reasons discussed above. When addressing these groups, it is essential to take this specific context into account. Dr MacDonald noted that not all people in these groups are strictly anti-vaccination and should not be viewed or treated as such. In order to address these different groups, data is needed. Coverage data can show how many people are unvaccinated or undervaccinated, and where pockets of those people live. Program data shows the efficiency of vaccine distribution. Behavioral and social data reveal barriers to vaccination among certain groups.

Using healthcare workers

The recommendation of a vaccine by a health worker is extremely influential in the decision to accept vaccines. “Educating healthcare workers about vaccines and strategies that work can dramatically increase vaccine uptake,” said Dr. MacDonald.

Use effective discussion techniques

Poorly delivered messages do not have as big an impact as well delivered messages. Even when the content is precise and solid, if the presentation doesn’t convey it, communication will be ineffective. It is also important to remember that high acceptance rates do not indicate that there is no concern about a vaccine. These concerns need to be addressed in well-constructed messages to increase confidence in immunization.

Treat the pain

An element often overlooked when trying to increase vaccine uptake is the pain and needle factor. Dr MacDonald said at least 10-15% of adults fear stings or pain from injections. Others have a much more serious phobia, which can be completely debilitating when it comes to getting the vaccine. Finding ways to reduce the pain and fear associated with vaccines is an important step in reducing hesitation in these people. Decreasing pain will also reduce vaccine stress reactions, such as fainting, headaches, fatigue and nausea, which are often used to reinforce fears and anxiety about vaccines.

Facilitate access

Dr. MacDonald pointed out that studies have shown that when a vaccination is provided by a school, acceptance rates are considerably higher than when the same vaccination is offered by a doctor’s office. Access is facilitated for parents who do not have to coordinate their child’s exit from school and the doctor’s office. For students, acceptance rates are high as it becomes a social norm. Other ways to improve ease of access are to pool vaccines and have more vaccination sites, especially in rural or low-income areas, with extended hours of operation. Meeting the needs of people with disabilities and ensuring people’s privacy are also important factors.

Manage disinformation

Dr MacDonald pointed out that there is a wide range of misinformation and that such misinformation has been shown to significantly reduce vaccine acceptance. Being aware of the strategies and techniques used to disseminate disinformation can help people identify when they are misinformed. It is also important to refute and correct misinformation when it does arise.

Express yourself

Dr. MacDonald concluded her presentation by emphasizing the importance of people speaking out to share accurate information. She explained that fear is powerfully persuasive and that silence is easily misinterpreted as support. Providing information to address peer concerns can make a big difference. Dr. MacDonald pointed out that there is nothing wrong with agreeing to disagree with someone who will not trust the information you give them. But, she said, it’s crucial to stress that there is no scientific debate about the importance of vaccination.

About the Coppoc One Health conference

Established in 2014, the Coppoc One Health Lecture Series is named after Dr Gordon Coppoc, Professor Emeritus of Veterinary Pharmacology at Purdue, and his wife, Harriet. Dr Coppoc is the former head of the Department of Basic Medical Sciences at Purdue Veterinary Medicine. He was also Principal of Indiana University School of Medicine-Lafayette and Associate Dean of Indiana University School of Medicine before retiring in 2014.

Hailee Rolofson, PVM communication intern | [email protected]


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