Vaccine safety anxiety driving parents towards misinformation

Morgan Liotta

16/02/2022 3:23:03 PM

How can GPs help combat this trend and ensure these patients don’t fall victim to misinformation?

Concerned parents talking to GP
GPs can strengthen the therapeutic relationship by being guided in conversation by parents’ concerns of vaccinating their children, experts say.

Anxiety experienced by expectant parents around medical processes such as vaccination can often push them towards questionable sources of information, a new Flinders University study has found.
The researchers made their findings after seeking to understand factors that influence vaccine decision-making in pregnant women and parents of children.
The three main influencing factors were identified as: vaccine safety concerns; the role of healthcare professionals; and alternative influences such as social media, friends and family, conspiracy theories and ‘salutogenic parenting’.
Parents seeking information via non-traditional sources such as social media can result in obtaining misinformation, a lack of vaccine confidence and subsequent vaccine refusal, the study found.
It also revealed high levels of anxiety associated with vaccine decision-making among parents seeking information from multiple sources, increasing the risk of more doors opening to misinformation.
The ‘very powerful, influential world of social media’ has been strongly linked to vaccine refusal and spreading medical misinformation.
But GPs have a major part to play in addressing these anxieties and providing the right information, Dr Andrew Leech, a GP with a special interest in paediatric health and mental health, told newsGP.
‘GPs have the privilege of seeing families at regular intervals,’ he said.
‘We see children at the six-week check, then again at four, six, 12, 18 months and at four years of age. We then also see them for all other childhood-related health problems that appear throughout their early years.
‘This provides many opportunities to discuss vaccinations as a routine part of the conversation around child health.’
Vaccine hesitancy is increasing in middle- and high-income countries, and is recognised as a key barrier to immunisation uptake, declared among the top 10 threats to global health by the World Health Organization in 2019.
Closer to home, rates of vaccine hesitancy have been declining steadily after peaking during the COVID-19 vaccine rollout, while Australia has overall coverage of around 95% for five-year-olds with regards to childhood immunisations on the National Immunisation Program schedule.
However, according to the Flinders University study, ‘significant uptake shortfall’ remains in some communities, as well as in antenatal immunisations, suggesting varying degrees of vaccine hesitancy.
And while pregnancy is an ideal time to provide education on both pregnancy and childhood vaccinations, some pregnant women and parents reported dissatisfaction in their therapeutic relationships with healthcare professionals whom they feel are ‘inadequately prepared to promote and provide antenatal and childhood immunisation’.
Some healthcare professionals also reported feeling inadequately prepared for the role, prompting calls from the authors for further training and support, and a consistent approach.
Dr Leech has some recommendations.
‘GPs have a key responsibility to promote and advocate for childhood immunisations [including during pregnancy] … raising the idea early and giving parents time to digest the information,’ he said. 
‘My focus is to spend around 80% of the time for discussion on the vaccine benefits, what diseases they are protecting from, the evidence of efficacy based on years of research, and the safety − both through studies but also anecdotally.
‘I’ve found one of the most powerful messages is to say my own two young children are both fully vaccinated.
‘I’ll then spend about 20% of the time discussing adverse effects including … that there can be rarer more serious side effects and leave it open to parents if they wish to discuss these.’
It is also important for GPs to ‘touch base at regular intervals’ to continue strengthening the therapeutic relationship and to be guided in conversation by the parents’ concerns and expectations of the appointment, Dr Leech said.
‘As we get busy, it can be hard and more tempting just to hand over families to the nurse for the injection to be given,’ he said.
‘But we might be missing a key opportunity here to counsel families on the importance of vaccination and have those open and honest discussions around concerns they might have.
‘If they genuinely have a concern about significant issues with vaccination, I will address these openly and honestly and point them to the relevant research or resource to help them.’ 
With the scourge of medical misinformation, particularly in the wake of COVID-19, Dr Leech echoes concerns identified by the Flinders University study that GPs can be ‘underutilised’ and ‘dominated’ by other sources of information such as social media, conspiracy theories or other parents.

‘Parents tend to turn to their own channels when they can’t get the information they need,’ he said.
‘[But] it has been shown that GPs are one of the most trusted sources of information when it comes to vaccines … and they should be confident [knowing this].
‘I’ve found the best way to have conversations with vaccine-hesitant parents is to not be dismissive, [but] rather try to understand their concerns and break it down for them.
‘Give them reliable, evidence-based resources to … inform them that this offers the maximum protection and has been developed with this in mind, then hopefully this will provide a sense of reassurance.
‘Focus on the benefits versus the risks, focus on the significant reduction in serious illness from disease, focus on the years of evidence and research and most importantly, the ability of vaccines to save lives.
‘We are very privileged to live in Australia where vaccinations are readily available and easy to access.’
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