Reflection and decision-making process Role of public health Risk perception and evaluation Role of...
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![Page 1: Reflection and decision-making process Role of public health Risk perception and evaluation Role of healthcare professionals MD RN Alternative med Counselling.](https://reader037.fdocuments.in/reader037/viewer/2022110401/56649e0e5503460f94af79b8/html5/thumbnails/1.jpg)
Reflection and decision-making process
Role of public health
Risk perception and evaluation
Role of healthcare professionals
MD RN Alternative med
Counselling
Training
Religious literacy
Open attitude
Payment vs time spent counselling
Vaccine delivery services
Vaccination programs
Impartiality / avoiding
appearance of conflict of interest
Relationship of trust
Leave time for the
decision to be made
Continuity Relationship of trust
Accurate information
Empowerment
Historic and socio-cultural
context
Link of trust
Religious and cultural
particularities
Communications and media
Social media
Internet
Ethics Spirituality
Medical expertise
Science PharmaceuticalcompaniesGovernment
Healthcare systems
Vaccine coverage
Rigorous evaluation
Vaccination registers
Avoid VPD epidemics
Population effects
Individual effects
Laws / incentives?
Message
Statistical data
Vaccine safety
Consequences / gravity of VPD
Different for each person
May not be rational
Perception changes when children or the vulnerable
involved
Low risk of undesirable
events
Very low incidence of
diseases, thus poorly known
Vaccine hesitancy
Communication skills
Medical and epidemiological
knowledge
Hesitant professionals
Educating Patients/parents
Recommend vaccination
Continuum of hesitancy
refusal acceptance
WORKSHOP ON THE CULTURAL AND RELIGIOUS ROOTS OF VACCINE HESITANCY:
ContextVaccine hesitancy causes a decrease in vaccine coverage and increases the risk of outbreaks and epidemics of vaccine-preventable diseases. Diseases believed to be controlled, such as measles, are reappearing today. A workshop was held on December 5, 2011, in Longueuil, Quebec, to consider this phenomenon of vaccine hesitancy. Some forty experts from various fields and from several Canadian provinces met to share their views (Figure 1). The workshop was structured as follows: short presentations were made on various themes related to vaccine hesitancy, for the purpose of encouraging a long period of discussion and debate among participants.
PurposeTo report workshop participants’ opinions.
During the workshop, the debates were recorded, and a short self-administered questionnaire was filled out by participants, whose opinions on factors contributing to vaccine hesitancy were solicited by means of several open questions. Minutes of the discussions were then written up and the content validated using the recordings. The questionnaire responses were compiled on Excel. A content analysis was carried out on all the material.
Method
The questionnaire response rate was 59% (22/37). For four major subjects—the role of healthcare professionals, the role of public health, the population’s perception and evaluation of risk, and the reflection and decision-making process (Figure 2), seven categories of factors were identified: communications and public exposure to vaccine information, the public’s level of knowledge about immunization, risk evaluation and decision-making, trust/mistrust, personal factors, the socio-cultural context, and the vaccination context (Table 1).
Results
Emotional, cultural, social and spiritual factors seem to influence the vaccination decision as much as cognitive factors. Healthcare professionals and public health bodies play a unique role with regard to vaccine-hesitant people. A dialogue must be established regarding vaccination decisions. To help professionals assume an empathetic, open-minded support role toward the hesitant population, the publication of a book on the subject is planned that will bring together the learning and ideas shared during this workshop.
Conclusion
Category Factors mentioned
Communication and public’s exposure to information(13/22)
Information communicated to the public (e.g. type of information, reliability, quantity, credibility)Information conveyed by health professionals (often hesitant themselves)Messages communicated by public health bodiesEducation offered on immunizationMedia, Internet, social networksExposure to anti-vaccination messages Importance placed on anecdotal data or controversies surrounding vaccines
Public’s level of knowledge about immunization(11/22)
Access to enough information on vaccinationKnowledge / lack of knowledge of risks of vaccine-preventable diseasesDifficulty observing directly the effects of vaccine-preventable diseasesKnowledge / lack of knowledge of vaccine efficacyKnowledge / lack of knowledge of scientific bases of vaccination
Risk evaluation and decision-making process(10/22)
Risk and benefit assessment process Enlightened decision-making Fear of side effects of vaccinesFear of undesirable adverse events of immunizationImportance placed on anecdotal events
Trust/mistrust(10/22)
Mistrust (general)Trust/mistrust in science, government, medicine, conventional healthcare, the health system, public healthMistrust of the big three (pharma, government and business)
Personal factors: - perceptions - personal opinions - membership groups (9/22)
Beliefs, values, knowledge, attitudesIdeologiesPersonal experiences or in one’s entourageSocio-economic status Religious or cultural membershipBelief in alternative medicine
Socio-cultural context (3/22)
Possibility of relying on group immunitySocial norms/acceptancePolarization of opinionsSocial valuesCultureReligionHistorical events / population’s experience
Vaccine delivery context(1/22)
Increase in number of vaccines recommended on the vaccine schedule Role played by health professionals
EXPLANATIONS AND IMPLICATIONS FOR CANADIAN HEALTHCARE (draft – do not disseminate)
Figure 2 – Determinants of vaccine hesitancy: schema summary of discussions
Hesitant mother
AnthropologistsMedical historian
Experts in ethics, psychology and risk perception
Expert in religious studies and multiculturalism
Humanities and social sciences
NursesFamily doctorsPediatricians
InternistMicrobiologistsChiropractor
Biomedical sciences
Family doctors Nurses
Medical specialistsEpidemiologists
Communication agents
Public health
Figure 1 – Workshop participants
Table 1 – Factors in vaccine hesitancy as mentioned by participants on the questionnaire (x mentions / 22 respondents)
Caroline Laberge; Maryse Guay; Paule Clément; Paul Bramadat; Réal Roy; Julie Bettinger