Addressing the ‘information tsunami’ around vaccination for teens

Earlier this month the RACGP backed the Australian Technical Advisory Group on Immunisation (ATAGI) move to allow the Pfizer COVID-19 vaccine to be administered to at-risk children aged 12–15.
 
Based on the latest advice from ATAGI, children in this age bracket with specified medical conditions that increase their risk of severe COVID-19, who are Aboriginal and/or Torres Strait Islander, or in remote communities as part of broader community outreach vaccination programs, are prioritised to receive the vaccine.
 
ATAGI is also expected to soon make further recommendations to the Federal Government regarding use in all other children aged 12–15 years following review of emerging information.
 
With vaccine counselling a key part of general practice’s contribution to the COVID-19 vaccine rollout, GPs are bracing for a surge of parents and carers seeking advice about vaccination for their children who meet the eligibility for priority groups in the 12−15 age bracket.
 
But GP and RACGP Specific Interests Child and Young Person’s Health Chair, Dr James Best is concerned there may be an ‘information tsunami’.
 
‘The amount of information available knocks people off their feet,’ he told newsGP.
 
‘The problem that is happening with the current adult vaccination rollout is that there’s not a problem with information, but there’s too much information, and a lot of misinformation.
 
‘This makes it very hard for the public to siphon through all that information, then they get confused, and then they get scared.
 
‘There’s a lot of fear and … the younger you go, the more this is going to become a problem. People get anxious around their health, but they get really, really anxious about their children’s health.’
 
Paediatrician and Murdoch Children’s Research Institute vaccine uptake expert, Associate Professor Margie Danchin, agrees.
 
‘It’s going to be very difficult,’ she told newsGP. ‘There’s a lot of concern about these vaccines anyway and … we’re hearing that many parents are very keen and young people are keen, but there’s a lot of concerns, so we need to clearly explain the benefits.’
 
For GPs to best support families in vaccine counselling, Associate Professor Danchin said there are some key points to be aware of.
 
‘The most important thing is awareness around vaccine eligibility,’ she said.
 
‘That can be very difficult. At the moment for the 12−15-year-olds, it’s a high-risk approach, but those lists of the underlying medical conditions listed in the ATAGI recommendations could actually be a bit tricky to understand.’
 
To avoid any confusion, Associate Professor Danchin said it is ‘critical’ to provide guidance to GPs, by linking closely to the ATAGI statement explaining the conditions associated with increased risk of COVID-19.
 
‘We’re getting a lot of questions around that. It might sound simple – I don’t think it is,’ she said.
 
‘For families particularly, knowing whether their child satisfies that criteria is really important.’
 
The next key part of the eligibility assessment process is weighing up the risks and benefits for the individual. Of particular concern is the risk of heart conditions in young males, according to Associate Professor Danchin.
 
‘The benefit is clearer if the individual is at higher risk,’ she said. ‘But then looking at the risk of myocarditis for young boys and men is going to be the next important conversation, and facilitating those resources.
 
‘Myocarditis is the main serious side effect for the teenage group. It is the equivalent of the blood clotting with the AstraZeneca [vaccine for older people], as well as pericarditis.’
 
Associate Professor Danchin highlighted that these conditions most commonly occur in males aged 12−30 years, but the most high-risk group is 19−24 years, mostly after the second dose of the mRNA Pfizer or Moderna vaccine.
 
‘So it is key that GPs know critically that they have to counsel teenagers [and their parents/carers] about this side effect, and especially young boys,’ she said.
 
‘The ATAGI guidance developed with cardiologists clearly shows you those groups that are listed as a precaution, meaning that those young men would need to discuss their vaccine eligibility very carefully with either a GP or an immunisation specialist and cardiologist who really understands what’s going on.’
 
Going back to the grassroots level, Dr Best said a solution to simplifying the deluge of information also lies in the doctor−patient relationship.
 
‘From a GP point of view, it really comes down to basic active listening techniques, and motivational interviewing techniques, that you basically hear patients’ concerns first before you jump in and start throwing information at them,’ he said.
 
‘As GPs, often we already have established a therapeutic relationship that is built on trust. And that trust deficit is much more important than any information deficit.
 
‘We might have to use information more when we’re answering questions, but really, the most important thing is that we basically build on trust, and then we deliver information that is relevant to that particular patient’s concerns.
 
‘If [patients] are hesitant or having concerns about vaccinations, particularly with children, then they can talk to their trusted GP … and they should be able to help filter out what is relevant and what is not, because there’s a lot of misinformation out there.’
 
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children and young people COVID-19 vaccine vaccine counselling