On April 6, 2020, the World Health Organization (WHO) Director-General, Dr. Tedros Ghebreyesus, announced an initiative to accelerate the development and distribution of a vaccine for SARS-CoV-2, the virus that causes COVID-19. While researchers have great hope that an effective vaccine can be expedited through safety and efficacy trials, many members of the public are skeptical about this sort of intervention despite the devastation wrought by the current pandemic.
Vaccine hesitancy is an established issue in public health, largely fueled by concerns about the claimed but disproven fear that inoculation causes autism. Apprehension about the safety of vaccines exists even though they have successfully reduced or eliminated morbidity and mortality from a range of infectious diseases. While a small percentage of people are inexorably opposed to vaccinations, close to 40 percent of parents occupy this middle ground of being unsure about the necessity and safety of vaccines. Health care professionals play a critical role in establishing a dialogue and facilitating constructive communication.
Vaccine-hesitant parents, deluged with information and misinformation from social media and friendship circles, are generally seeking understanding rather than confrontation when they arrive at pediatrician appointments. If physicians adopt a critical and judgmental tone, patients can find it difficult to voice their questions and concerns. Productive discussions about vaccines require effort, patience, and clarity from both parties. Physicians should be prepared to answer a number of potential questions:
- Why are vaccines necessary?
- What are the risks of not vaccinating?
- What is the difference between natural immunity and immunity from vaccines?
- What are vaccine timelines and why are there schedules?
- What is the purpose of multiple doses simultaneously?
- What are the known side effects of a vaccine?
- What are the ingredients of a particular vaccine ?
- What is the safety of particular additives and preservatives, most notably mercury?
Physicians must exhibit compassion in seeking to build a trusting partnership. It is understandable they would become frustrated at regularly having to counteract untrue myths about vaccines, but they should first try to acknowledge patients’ fears and then respectfully present evidence-based information. This should include transparent details about the formulation and preservation of vaccines and the research that has been conducted to ensure they meet safety standards.
Overall, physicians should approach conversations with an understanding of growing concerns about freedom of choice and autonomy, and mention vaccines’ benefits to society and other individuals. Yet face-to-face interventions strictly based on providing practical and statistical information are likely to be ineffective, particularly if parents’ apprehensions arise not just in a lack of knowledge but from active acceptance of mistruths and ideological arguments. While these parents make up a minority of the vaccine-hesitant population, clinical interactions solely defined by presenting scientific information will not be enough to result in behavior change. If physicians devote more time and effort into understanding and addressing patients' specific concerns, there will be a higher satisfaction rate among patients and better compliance with recommended vaccines.
In the coming months, physicians may find themselves addressing the need and utility of a vaccine for SARS-CoV-2 with patients. When discussing the vaccine and its potential to mitigate future destruction caused by the virus, it is crucial that health care practitioners, as well as other educated vaccine advocates, engage constructively with vaccine-hesitant individuals in the community. It is through active listening, consideration of differing values, and transparency in scientific discourse that constructive communication and vaccination compliance will occur.