Anti-vaxxers may be a lost cause but the vaccine-hesitant must be brought on board
Distinguishing between “vaccine hesitancy,” a term that has gained traction in recent years, and anti-vaxxers is vital if we are to bring the pandemic under control.
Anti-vaxxers can rarely be persuaded to give up their fixed beliefs that all vaccines are harmful. Numerous sources have recommended that health professionals focus on those who are vaccine-hesitant instead, be it from active misinformation on social media or a lack of confidence in the safety of vaccines. Notably, a recent poll shows that 24 per cent of Canadians are undecided about whether they will get a COVID-19 vaccine. Additionally, only 65 per cent of Canadians are willing to receive a safe COVID-19 vaccine upon availability, a decrease from 71 per cent of Canadians polled in April. The reasons behind this worrying rise included concerns about the safety and effectiveness of the novel vaccine.
The World Health Organization recently published a report suggesting three main ways to overcome vaccine hesitancy: cultivating social influencers in favour of vaccination (countering disinformation); curating vaccine-enabling environments (ensuring vaccines are accessible to marginalized communities); and motivating individuals to get vaccinated.
Increased exposure to anti-vaccine blogs increases vaccine hesitancy. Social media is a leading source of vaccine misinformation globally and as people enclose themselves in echo chambers, they become difficult for public health experts to reach. For quite some time, social media companies have been reluctant to regulate harmful content on their platforms, either citing freedom of speech provisions or simply deflecting responsibility for what individuals share. Governments around the world, however, are forcing them to act in the interests of public safety. Consequently, Google, Facebook and Twitter are actively removing pages that post vaccine misinformation just as governments ramp up efforts to maximize messaging reinforcing the safety and efficacy of vaccines.
Within promotional social media campaigns, leveraging the influence of trusted community leaders, physicians and nurses is crucial as it can generate the needed public trust in the vaccine.
We must also ensure the removal of systems-level barriers that prevent many racialized and low-income communities from equitably accessing vaccines – often the same barriers behind the disproportionate prevalence of COVID-19 in these communities and the limits in obtaining testing. We have seen examples of creative and effective efforts in Toronto to ramp up testing, converting public transit buses into mobile testing centres and opening pop-up clinics in community centres. Similar measures should be considered to create a vaccine-enabling environment and bring vaccines to the populations that need them most.
Even with these fixes, individual motivation is the final, rate-limiting step to beating back COVID-19. Many vaccine-hesitant individuals undervalue the risks of contracting the virus and overvalue the safety concerns of a novel vaccine. Indeed, a recent study on the HPV vaccine found that parents are often reluctant to vaccinate their children because of safety concerns or simply not understanding the importance of the vaccine. Addressing both of these risks head on, in a non-judgmental manner, is key to motivating them to change their views. Real-life interactions are where we as health professionals can transform attitudes toward vaccination. Studies continue to show that healthcare professionals remain the most trusted source of health-related information. Direct communication with patients increases the likelihood of vaccine uptake.
So, the next time you encounter patients or family members concerned about the vaccine, make sure to take a deep breath, direct your full, empathic attention to them, sit at their level and make eye contact. Then gently, politely recite the facts: the vaccines are our exit strategy and how we get out of this mess; for them to be effective, at least 70 per cent of Canadians need to be vaccinated; the vaccines were approved by Health Canada on the basis of serious evidence; each trial enrolled tens of thousands of people with no serious problems; a couple of the vaccines are based on a newer technology which seems to work really, really well to build immunity against coronavirus with no known serious side effects.
And, most importantly, without vaccinations, the waves may keep rolling.
Urooj Khan is a fourth-year Biomedical Sciences student at Ryerson University and a volunteer with the Critical Drugs Coalition.
Abdulwahab Sidiqi is a fourth-year medical student at the University of Toronto, has an interest in clinical education and is a co-founder of the Critical Drugs Coalition.
Saad Ahmed is a rural physician, lecturer at the University of Toronto, and co-founder of the Critical Drugs Coalition. He has worked in remote and rural settings and in ERs and inpatient wards, informing and influencing his passion for action on the social determinants of health.
Kashif Pirzada is an emergency physician in Toronto, a faculty member at the University of Toronto, and he leads COVID-19 initiatives, including as a co-founder of the Critical Drugs Coalition and co-chair of the community group Masks4Canada.