The issue of vaccination hesitancy and refusal often makes headlines in the media and worries health authorities. However, a new study by Dr. Anat Gesser-Edelsburg, Dr. Yaffa Shir-Raz and Prof. Manfred S. Green from the University of Haifa, School of Public Health, published in the Journal of Risk Research, suggests that even parents who are not “vaccine refusers” and who usually do comply with routine vaccination programs, may hesitate or refuse to vaccinate their children. Such refusal, the study concluded, is based on poor communication from relevant healthcare providers and on concerns about the safety of the vaccine.
The study examined parents’ refusal or hesitancy to vaccinate their children following the 2013 polio outbreak in Israel. While no clinical cases of paralytic polio were recorded during the outbreak, the Israeli Health Ministry launched a campaign to immunize children under the age of 10 – who were already protected with the standard Inactivated Polio Vaccine (IPV) – with an Oral Polio Vaccine (OPV). This new vaccine is designed to protect others who have not already been vaccinated against the disease.
The study drew from results of a questionnaire survey and content analyses of parents’ discussions in blogs, internet sites, and Facebook. Although the rate of children vaccinated during the campaign was high, the study’s findings indicate that parents who are not “vaccine refusers” and who usually comply with routine vaccination programs hesitated or even refused to vaccinate their children. One-third of these “vaccine refusing” parents reported that the safety of the vaccine was a concern, and that they were not convinced by the information communicated by the Health Ministry regarding either the vaccine or its necessity.
Over a third of all respondents strongly disagreed that the Health Ministry had provided comprehensive and clear information about the reasons for giving children the vaccine, and almost 28% of the parents who did vaccinate their children indicated that they did not actually understand that the purpose of the vaccine was not to protect their own child, but rather to protect others.
The researchers went on to suggest that, in the long term, the perceived ambiguity in communications could create mistrust in the health care system. The theme of distrust in the medical field recurred in an analysis of 35 respondents who had refused or were hesitant about vaccinating their child. This analysis brought to the fore the importance of transparency and credibility in health communication. For example, the Health Ministry claimed that the OPV vaccine had ‘zero side effects’. Findings indicated that claims of no risk were interpreted as neither respecting the public nor as credible. The researchers recommended that in the future the risk-communicating organizations should expose the dilemmas, communicate facts, and ‘talk science’ even to laypeople, especially in conditions of uncertainty. As the researchers stated, “The communicators must educate the public and include it, and must not speak in all-or-nothing terms”.