Vaccines are one of the greatest contributions to public health, yet millions of children and adults with access to vaccines remain unvaccinated. A large portion of the global population continues to question the efficacy and safety of immunization. While this hesitancy is not a new phenomenon, the COVID-19 pandemic has contributed to one of the most recent and significant spikes in skepticism toward vaccinations. More than two years since the initial COVID-19 vaccine rollout, nearly a quarter of Americans remain unwilling to vaccinate.
Healthcare providers play an instrumental role in moving the needle to more positive vaccine attitudes. To help overcome doubt around vaccine safety and effectiveness, it’s critical to understand why individuals are apprehensive about vaccines and where their attitude toward immunization stems from.
Understanding Vaccine Hesitancy
Vaccine hesitancy embodies the conflictedness or unwillingness of individuals or communities to receive vaccinations, despite the availability and accessibility of immunization services. The prevalence of vaccine hesitancy has fluctuated over time and exists on a spectrum, with some individuals having mild concerns over one particular vaccine and others who refuse to receive immunization altogether for themselves or their children. This complex and circumstance-specific ideology is influenced by a variety of factors including fear of side effects, rejection of societal pressure, low perception of efficacy, negative past experiences with vaccination services, misinformation, complacency, and healthcare inequity. More recently, and in the case of COVID-19, factors like social media and political partisanship have played an increasingly significant role in public perception around vaccines, contributing to nearly half the variation in vaccination rates at the state level.
This phenomenon is far from new. For example, when the human papillomavirus (HPV) vaccine became available in 2006, parents were initially uneasy about vaccinating their adolescent children. To address these concerns, healthcare providers shifted their communication strategy by addressing parents’ anxieties and shifting the focus of the conversation to the long-term benefit of the vaccine: preventing cancer. Through these efforts, along with public health campaigns, vaccination uptake drastically improved and cancer rates decreased rapidly. Research published by the CDC has demonstrated 90% efficacy of HPV vaccination in preventing cancers caused by HPV, as well as anal, vaginal, cervical, and vulvar precancers.
Overcoming Barriers to Vaccine Acceptance
Vaccine attitudes can change over time, particularly as new information becomes available and widescale interventions are introduced. When healthcare providers are prepared to address patients’ concerns, they can strengthen confidence in vaccination services and reignite a culture of immunization in their communities. Recent studies have shown a few cost-effective strategies providers can implement to help overcome vaccine hesitancy.
Identify and measure barriers: The first step to addressing negative vaccine attitudes is to understand the root cause. Tools like the 5C model can help measure hesitancy drivers such as attitude, behavior, and access, to tailor your approach and identify emerging trends within your patient population.
Build trust: Listen to patients’ concerns, validate their emotions, and address their questions or doubts with empathy and respect. Avoid punitive or dismissive language; instead, lead with compassion and curiosity if the patient has mixed feelings or is misinformed about immunizations.
Provide clear and consistent messaging: Offer reliable information about vaccines, their safety and efficacy, and the diseases they prevent. Use clear and simple language, avoiding medical jargon, and provide educational materials or trusted online resources for patients and families to explore on their own.
Emphasize vaccine safety: Clearly explain the rigorous safety protocols and monitoring systems in place for vaccines. Discuss the extensive testing and regulatory processes vaccines undergo before they are approved for public use.
Share real-word examples: Present data and other facts to help instill confidence. Unprotected People Stories is an online resource with 100 real-life accounts of people who suffered or died from vaccine-preventable diseases.
Collaborate with colleagues and community members: Work collaboratively with other healthcare providers, nurses, and staff to create a unified and consistent message regarding vaccines. Seek out partnerships with other organizations that provide valuable resources.
For any of these strategies to be successful, it’s important to meet the patient where they are. Addressing vaccine hesitancy may require ongoing conversations and multiple tactics before there’s a shift in attitude. By consistently applying these strategies, healthcare providers can protect patients against vaccine-preventable diseases and can help avoid future outbreaks, moving our communities toward a culture of vaccine confidence.