Vaccine hesitancy
Addressing vaccine hesitancy in immunization programs, clinics and practices
This practice point offers evidence-based guidance for provincial/territorial immunization programs, clinics and office practices on how to address hesitancy and improve vaccine uptake rates. Steps to take include the following: 1) Detecting under-immunized subgroups (which requires record-keeping), diagnosis and targeted interventions; 2) Educating all health care workers involved with immunization on best practices; 3) Employing evidence-based strategies to increase uptake, including reminders, convenient clinic hours and locations, and tailored communication; 4) Educating children, youth and adults on the importance of immunization for health; and 5) Working collaboratively across provincial/territorial jurisdictions and with the federal government, nongovernmental organizations, community leaders and health services.
Contrer la réticence face à la vaccination dans les programmes de vaccination, les cliniques et les cabinets
Le présent point de pratique contient des conseils fondés sur des données probantes à l’intention des programmes de vaccination provinciaux et territoriaux, des cliniques et des cabinets afin de contrer la réticence face à la vaccination et d’améliorer les taux de vaccination. Les étapes à privilégier s’établissent comme suit : 1) définir les sous-groupes sous-vaccinés (ce qui exige la tenue de registres), les facteurs responsables de la réticence face à la vaccination et les interventions ciblées; 2) enseigner les pratiques exemplaires à tous les dispensateurs de soins qui participent à la vaccination; 3) faire appel à des stratégies fondées sur des données probantes pour accroître les taux de vaccination, y compris les rappels, un emplacement des cliniques et des heures d’ouverture pratiques et des communications adaptées; 4) informer les enfants, les adolescents et les adultes de l’importance de la vaccination pour la santé et 5) travailler en collaboration avec les régions sociosanitaires provinciales et territoriales et avec le gouvernement fédéral, les organismes non gouvernementaux, les leaders communautaires et les services de santé.
La « littératie vaccinale » : les stratégies et connaissances pour promouvoir la vaccination
La littératie en santé influence la capacité des gens à s’engager dans des activités de prévention. Parmi les trois déterminants de l’hésitation vaccinale – la confiance, la complaisance et la commodité – le dernier est concerné lorsque, entre autres facteurs, la capacité à comprendre (savoir le langage) peut avoir un impact sur la décision de se faire vacciner.
Les parents qui hésitent à faire vacciner leurs enfants : une mise à jour
La plupart des parents canadiens s’assurent que leurs enfants soient vaccinés aux moments prévus, mais les dispensateurs de soins rencontrent souvent des parents réticents face à la vaccination ou qui refusent les vaccins recommandés. Le présent point de pratique propose aux cliniciens des conseils fondés sur des données probantes afin de composer avec les parents qui hésitent à faire vacciner leur enfant. Les étapes s’établissent comme suit : 1) Comprendre le rôle essentiel du dispensateur de soins dans la prise de décision des parents et ne pas exclure de sa pratique ceux qui refusent la vaccination; 2) utiliser des techniques d’entrevue axées sur la présomption et la motivation pour cibler les inquiétudes précises à l’égard des vaccins; 3) dans une langue claire et concrète, présenter avec justesse et précision les données démontrant les risques des maladies et les avantages des vaccins; 4) soulager la douleur causée par la vaccination et 5) insister sur le fait que la « protection collective » n’est pas garante d’une protection individuelle. La vaccination est l’une des mesures de santé préventives les plus importantes, puisqu’elle a sauvé des millions de vies. Il est prioritaire de répondre aux inquiétudes des parents qui hésitent à faire vacciner leurs enfants.
Reasons for non-vaccination: Parental vaccine hesitancy and the childhood influenza vaccination school pilot programme in England
The aim of this study was to explore the reasons some parents decided not to vaccinate their child against influenza as part of the pilot programme offered in [UK] schools.
The vaccine hesitancy scale: Psychometric properties and validation
The SAGE Working Group on Vaccine Hesitancy developed a vaccine hesitancy measure, the Vaccine Hesitancy Scale (VHS). This scale has the potential to aid in the advancement of research and immunization policy but has not yet been psychometrically evaluated.
Vaccine hesitancy, refusal and access barriers: The need for clarity in terminology
Although vaccination uptake is high in most countries, pockets of sub-optimal coverage remain, posing a threat to individual and population immunity. Increasingly, the term ‘vaccine hesitancy’ is being used by experts and commentators to explain sub-optimal vaccination coverage. The authors contend that using this term to explain all partial or non-immunization risks generating solutions that are a poor match for the problem in a particular community or population. The authors propose more precision in the term ‘vaccine hesitancy’ is needed, particularly since much under-vaccination arises from factors related to access or pragmatics.
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.