News

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Aggressive responses likely crystalise vaccine uncertainty: Study

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New Flinders University research has found that aggressive responses to people voicing concerns about vaccination can worsen fear and anxiety, further hardening suspicion around immunisation.
 
The study used a purpose-designed Facebook page as a forum to share views on vaccination. Content posted on the page by its audience was analysed to gain a deeper understanding of online information and misinformation, as well as the influence social media has on parental vaccine decision-making.
 
Despite a strong evidence-base for vaccination, vaccine hesitancy is increasing and has been declared one of the top 10 threats to global health by the World Health Organization (WHO). In Australia, nearly half of parents have at some point experienced concerns about childhood immunisation.
 
Among the thousands of posts on the Facebook page, several major themes emerged, including: 

• pregnancy immunisation concerns
• an emotional debate involving fear
• anxiety and even aggression
• COVID-19-specific issues, such as the involvement of Big Pharma and mandated vaccination.

The study’s author, Dr Susan Smith, reveals a range of conspiracy theories were also voiced on the forum.
 
‘A bizarre and yet commonly believed theory claimed that vaccinations against COVID-19 were part of a plot by Freemasons as a means of birth control,’ she told newsGP.
 
Dr Smith admits that the unexpected finding, however, was the amount of abuse delivered online – not just from those against vaccination, but also from those for it.
 
‘It didn’t matter which side users were on, they still managed to name-call,’ she said.
 
‘There was a lot of swearing and calling people idiots or guinea pigs and this has the potential to cause fear and anxiety in the undecided.
 
‘Proponents of vaccination tended to ridicule, rather than encourage, a healthy discussion that may have in fact helped a parent to understand the benefits of immunisation.’
 
As a former maternal child health nurse, Dr Smith warns that pregnant women and new parents are particularly vulnerable to being permanently alienated.
 
‘Education around vaccines needs to be done before a baby is even born because this is when parents will make a potentially life-long decision as to whether or not their child will ever be vaccinated,’ she said.
 
‘Aggressive messaging from either side creates a lot of confusion and anxiety at such an important time in someone’s life.
 
‘Instead, you really need to have balanced and sensitive messaging.’
 
Dr Smith advocates for health professionals to be more active on or, in the very least, more aware of the power of social media.
 
‘We can’t ignore social media – it is the future, but it is poorly moderated and confusing,’ she said.
 
‘We as health professionals need to be more active on there and get accurate information online to counteract the misinformation.’
 
While Dr Smith highlights the vital role of GPs as major immunisation providers, when informing patients to make decisions she concedes that time constraints can make balanced counselling challenging.
 
‘We don’t always have time as clinicians to listen comprehensively to what makes people think the way they do,’ she said.
 
‘And unfortunately, GPs are very time-poor compared to nurses and midwives.’
 
TV Presenter and Melbourne GP, Dr Preeya Alexander, feels strongly that GPs should be taking the initiative on social media.
 
‘There are pros and cons … social media can connect people for support, but it is terrifyingly efficient at widely disseminating health misinformation,’ she told newsGP.
 
‘It gives people who are unqualified a really big platform. This can be really damaging and a lot of us see the consequences of this in our consulting room.
 
‘It’s here to stay though, so more of us GPs need to get on there as a qualified voice and combat the misinformation.’
 
Dr Alexander admits that battling misinformation is a complex process, which starts by exposing oneself to online content to understand a patient’s mindset.
 
‘GPs need to be aware of what kind of misinformation our patients are exposed to online so that we are better equipped to counsel and support them,’ she said.
 
‘We can’t be sitting in our consulting rooms assuming that we are the only source of health information for our patients.
 
‘We need to actually go on to social media and witness how frightening the content is so we can understand why people are scared and hesitant to get COVID-19 or flu vaccine boosters.
 
‘Fearmongering has done a lot of damage and promotes a biased opinion of “if something happened to me when I had a treatment, then nobody should be having it”.’
 
Like Dr Smith, Dr Alexander recommends a gentle and non-judgemental approach so as not to overwhelm.
 
‘I try to stay balanced by giving patients digestible pieces of information without demanding that they go and do something,’ she said.
 
‘When the messages get too aggressive with vaccinations it tends to backfire. People get overwhelmed by too much information and too many opinions.
 
‘I simply talk about why I vaccinated my own kids and suggest why they might want to do the same.
 
‘As much as we may want to scream from the rooftops that vaccination is a no-brainer, we have to acknowledge that patients live in a world that’s been muddied by lots of unregulated information on social media. Our role is to support and guide them back to the evidence.’
 
Dr Alexander also feels the health system needs to allow GPs to undertake proper preventive healthcare, including through more ubiquitous public health messaging and better remuneration.
 
‘I have been disappointed in the lack of public health messaging in everyday life. I can’t believe that we don’t have billboards, buses and trams with really key simple public health posts on exercise, healthy diet and childhood vaccinations,’ she said.
 
‘GPs are time-strapped so ideally the patient should already be coming in curious about a health issue and saying, “I saw this on a billboard, can we talk more about it?”
 
‘And where is the specific MBS item number for us to take the actual time needed to properly counsel a patient on preventive health?’
 
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childhood vaccinations health literacy health misinformation social media vaccine hesitancy

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