Vaccine accine acceptance or acceptance or refusal?: efusal?: Ind - - PowerPoint PPT Presentation

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Oct 03, 2022 433 likes •805 views

Vaccine accine acceptance or acceptance or refusal?: efusal?: Ind Individu ividual al cho hoice ice vs vs so socie cieta tal l ne need eds or or My risks vs our risks Heidi J. Larson The Vaccine Confidence Project Faculty

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Vaccine accine acceptance or acceptance or refusal?: efusal?:

Ind Individu ividual al cho hoice ice vs vs so socie cieta tal l ne need eds

My risks vs “our” risks

Heidi J. Larson The Vaccine Confidence Project Faculty of Epidemiology and Population Health LSHTM

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Risk as feelings

lings

(fast , instinctive, emotional.. ) Risk as analysis (logic, reason, scientific...) Risk as Po Poli litics tics

Adapted from Slovic et al. Risk Analysis 2004; 24 (2): 311-22

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So what do we need to do??

Scientists (and the Media!) must not to treat fear

and reservation as ignorance and then try to destroy them with a blunt “rational” instrument.

Pattison – BMJ 2001;323:838-840

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In the 19th Century

Principles were not well understood
Vaccination is ineffective.
Vaccination is not safe.
Religious and philosophical concerns.
Resistance to compulsory vaccination.

In the 21st Century

Principles STILL not well understood
Perception that vaccination is not needed
Concerns about vaccine safety
Religious and philosophical concerns
Resistance to compulsory vaccination

Reasons easons for

r vaccine hesitanc

vaccine hesitancy and opposition y and opposition

Heidi.larson@lshtm.ac.uk

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Vac accine cine he hesita sitanc ncy y an and d risk risk pe perce cept ption ion

heidi.larson@lshtm.ac.uk

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WHO Guidance

But what about the perception of safety??

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Prompters of questions and risk perceptions

Adverse Event (AEFI) –local AEFI are usually stronger

prompters of rumors, but a distant event reported can also spread and provoke questions

New research reported
New recommendation or policy change
New product (introduction of new product or product

packaging)

Larson/Restoring Public Trust

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http://www.gmofreeglobal.org/en/mission

Perceptions are also about motives

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Wo Worl rld Economic Forum: rum: Global Risk sks s 2013

Heidi.larson@lshtm.ac.uk

OPPORTUNITY or RISK?

The role of social media

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2013 Global Risks Report -World Economic Forum

Heidi.larson@lshtm.ac.uk

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Report of the Independent Monitoring Board of the Global Polio Eradication Initiative November 2012

Result of 2003-2004 rumour-driven vaccine boycott

Heidi.larson@lshtm.ac.uk

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Herd immunity or Herd mentality?

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Wakefield Lancet Article

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Determinants of vaccine hesitancy

Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review

f published literature, 2007-2012.

Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Vaccine. 2014 Apr 17;32(19):2150-2159.

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Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007-2012. Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Vaccine. 2014 Apr 17;32(19):2150-2159.

Articles about vaccine hesitancy by year and WHO region [n = 1164]

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Can we monitor public confidence in vaccines?

Heidi.larson@lshtm.ac.uk

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Heidi.larson@lshtm.ac.uk

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Tracking Anti-vaccination Sentiment in Eastern European Social Media Networks. UNICEF .2013

Influences on risk perceptions are highly varied

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Tracking Anti-vaccination Sentiment in Eastern European Social Media Networks. UNICEF .2013

Modes of communication differ by location

Heidi.larson@lshtm.ac.uk

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Perceptions of risk can have serious impacts

In the Philippines, risk perceptions that

tetanus vaccines caused sterilization led to a 45% drop in coverage between 1994 and 1995

In 1998, Andrew Wakefield’s publication linking MMR vaccine to bowel disease and

autism caused public confidence to plummet. MMR coverage rates in England dropped from nearly 93% in 1997 to 79.9% in 2003-04 due to risk perceptions

In Japan, adverse events following HPV vaccination, amplified by negative media and a

highly vocal victim support group led the government to withdraw their HPV recommendation (despite no evidence of vaccine-link) and HPV vaccine uptake plummeted from over 70% to under 10% between 2013-2014.

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Vaccine ine Risk Risk Perceptions an ions and Ad H Ad Hoc Ri Risk sk Co Commu mmunica ication: ion: An An E Empir mpirical ical Asse Assessmen ssmentDan M. Kahan

Although perceptions may seem to not have an immediate impact, they can have longer term impacts

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NAIROBI. MAY 2013 (25 years post-MMR Wakefield scare—risk perceptions travel)

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heidi.larson@lshtm.ac.uk

The nature of vaccine concerns also vary Globally, by vaccine and over time

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heidi.larson@lshtm.ac.uk

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Larson, et al Measuring Vaccine Confidence Lancet ID . 2013

POSITIVE SENTIMENT REPORTS

Heidi.larson@lshtm.ac.uk

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NEGATIVE SENTIMENT REPORTS

Heidi.larson@lshtm.ac.uk

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Ne New w res esear earch s h sho hows ws tha that tr t trying to c ying to change hange ne nega gativ tive per e perceptions ceptions can mak can make things w e things wor

se

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Source: Peter Sandman. http://www.psandman.com/articles/zurich.pdf

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Culture Personal Beliefs Politics Society Scientific Evidence Media

TRUST

TRUST and RESPECT

can be the tipping point..

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Larson et al. Drug Safety 2012; 35(11)

Risk/benefit communication is only part of an

ngoing dynamic process…

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Vaccine accine acceptance or acceptance or refusal?: efusal?:

Ind Individu ividual al cho hoice ice vs vs so socie cieta tal l ne need eds

My risks vs “our” risks

Risk as feelings

lings

(fast , instinctive, emotional.. ) Risk as analysis (logic, reason, scientific...) Risk as Po Poli litics tics

So what do we need to do??

Pattison – BMJ 2001;323:838-840

In the 19th Century

In the 21st Century

Reasons easons for

vaccine hesitancy and opposition y and opposition

Vac accine cine he hesita sitanc ncy y an and d risk risk pe perce cept ption ion

But what about the perception of safety??

Prompters of questions and risk perceptions

prompters of rumors, but a distant event reported can also spread and provoke questions

packaging)

Perceptions are also about motives

OPPORTUNITY or RISK?

The role of social media

Herd immunity or Herd mentality?

Determinants of vaccine hesitancy

Articles about vaccine hesitancy by year and WHO region [n = 1164]

Can we monitor public confidence in vaccines?

Influences on risk perceptions are highly varied

Modes of communication differ by location

Perceptions of risk can have serious impacts

tetanus vaccines caused sterilization led to a 45% drop in coverage between 1994 and 1995

autism caused public confidence to plummet. MMR coverage rates in England dropped from nearly 93% in 1997 to 79.9% in 2003-04 due to risk perceptions

highly vocal victim support group led the government to withdraw their HPV recommendation (despite no evidence of vaccine-link) and HPV vaccine uptake plummeted from over 70% to under 10% between 2013-2014.

Although perceptions may seem to not have an immediate impact, they can have longer term impacts

The nature of vaccine concerns also vary Globally, by vaccine and over time

Ne New w res esear earch s h sho hows ws tha that tr t trying to c ying to change hange ne nega gativ tive per e perceptions ceptions can mak can make things w e things wor

se

Culture Personal Beliefs Politics Society Scientific Evidence Media

TRUST and RESPECT

can be the tipping point..

Risk/benefit communication is only part of an

www.vaccineconfidence.org