Hésitation à la vaccination
Working with vaccine-hesitant parents: An update
Most Canadian parents make sure their children are immunized on time, but health care providers often encounter parents who are hesitant about vaccination or refuse recommended vaccines. This practice point offers evidence-based guidance to clinicians on how to work with vaccine-hesitant parents. Steps include: 1) Understanding the health care provider’s key role in parental decision-making and not dismissing vaccine refusers from practice; 2) Using presumptive and motivational interviewing techniques to identify specific vaccine concerns; 3) Using effective, clear language to present evidence for disease risks and vaccine benefits fairly and accurately; 4) Managing pain on immunization; and 5) Reinforcing the importance of and parental responsibility for community protection. Immunization is one of the most important preventive health measures in existence and responsible for saving millions of lives. Addressing the concerns of vaccine-hesitant parents is a priority for health care providers.
Determinants of non-vaccination and incomplete vaccination in Canadian toddlers
Vaccination coverage remains suboptimal in Canada and sporadic outbreaks of vaccine-preventable diseases such as measles and pertussis continue to occur. This study was undertaken to identify sociodemographic determinants of total non-vaccination (having never received any vaccine), non-vaccination for measles (0 doses) and incomplete vaccination for pertussis (< 4 doses) among 2-year-old Canadian children. Data from the 2013 Childhood National Immunization Coverage Survey (CNICS) were used. Associations between sociodemographic factors and outcomes were measured by multiple logistic regressions and adjusted odds ratios (aOR) were calculated. A total of 5,477 children were included in the analyses of total non-vaccination, and 3,899 children were included in the analysis of non-vaccination for measles and incomplete vaccination for pertussis. Overall, 2.7% of children (95% CI 2.0–3.3) had received no vaccine at all. Lower parental education, i.e., the responding parent having a high school diploma, trade certificate or less (compared with university graduation) was associated with total non-vaccination (aOR 1.99, 95% CI 1.02–3.91). Non-vaccination for measles was more frequent among children of single parent families (aOR 1.63, 95% CI 1.01–2.61) and those of parents with lower education (aOR 1.86, 95% CI 1.26–2.76). The odds of incomplete vaccination for pertussis was greater among children born outside Canada (aOR 3.10, 95% CI 1.73–5.58), of parents with lower education (aOR 1.92, 95% CI 1.41–2.62), and those whose household income was between $40,000 and $59,999 (aOR 1.47; 95% CI 1.04–2.07) or lower than $40,000 (aOR 1.58, 95% CI 1.13–2.22). Significant regional variation was also found for all outcomes. In conclusion, despite universal access to free childhood vaccines in Canada, regional variation and socioeconomic inequalities in vaccine uptake were still observed. Further analyses are warranted to identify barriers contributing to these variations.
Making the CASE for Vaccines: A new model for talking to parents about vaccines
It is important to listen carefully to the concerns parents raise regarding vaccines and autism. It is our job as medical and public health professionals to explain the science in a new way. The CASE method combines emotional and scientific talking points to sway parents' emotional responses and help them face the issue more logically.
Parents of young children are more ‘vaccine hesitant’
A solid majority of Americans believe vaccinating their children against measles, mumps and rubella has high preventive health benefits. But several groups – particularly parents of young children – are less convinced of the benefits and more concerned about the safety of the MMR vaccine.
Practical Approaches to Optimize Adolescent Immunization
With the expansion of the adolescent immunization schedule during the past decade, immunization rates notably vary by vaccine and by state. Addressing barriers to improving adolescent vaccination rates is a priority. Every visit can be viewed as an opportunity to update and complete an adolescent’s immunizations. It is essential to continue to focus and refine the appropriate techniques in approaching the adolescent patient and parent in the office setting. Health care providers must continuously strive to educate their patients and develop skills that can help parents and adolescents overcome vaccine hesitancy. Research on strategies to achieve higher vaccination rates is ongoing, and it is important to increase the knowledge and implementation of these strategies.
Vaccine Hesitancy: In Search of the Risk Communication Comfort Zone
This paper reports the findings of a national online survey to parents of children aged 5 and younger. The objectives of the study were to assess parental understanding of childhood immunizations, identify sources of information that they trust for vaccine-related content, assess where parents with young children stand on the key issues in the public debate about vaccination, and identify which risk communication messages are most effective for influencing the behaviours of vaccine hesitant parents.
Web-based Social Media Intervention to Increase Vaccine Acceptance: A Randomized Controlled Trial
Interventions to address vaccine hesitancy and increase vaccine acceptance are needed. This study sought to determine if a web-based, social media intervention increases early childhood immunization. The results demonstrate that web-based vaccine information with social media technologies can positively influence parental vaccine decisions. As a complement to routine well-child care, the information appears to be effective when presented to parents before their children are born.
Les parents qui choisissent de ne pas faire vacciner leur enfant : les risques et les responsabilités
Cette ressource a été adapté de « Si vous décidez de ne pas vacciner votre enfant, vous devez avoir conscience des risques et de la responsabilité que vous prenez » (Bureau régional de l’Organisation mondiale de la santé pour l’Europe), et révisée par le Comité des maladies infectieuses et d’immunisation de la Société canadienne de pédiatrie. Cette version adaptée au contexte canadien est utile pour les professionnels de la santé, qui peuvent la partager avec les parents et les gardiens.
Vaccine hesitancy and healthcare providers
While most people vaccinate according to the recommended schedule, this success is challenged by individuals and groups who delay or refuse vaccines. The aim of this article is to review studies on vaccine hesitancy among healthcare providers, and the influences of their own vaccine confidence and vaccination behaviour on their vaccination recommendations to others.
Vaccine Hesitancy: Tools to address problems at the population, public and individual levels
Speaker presentation at the Canadian Immunization Conference 2016.