Opinion versus evidence: Searching for vaccine certainty

When it comes to considering vaccines, doctors in the UK and the US have a different challenge to those of us working in Australia.
 
With such high infection and death rates over there, the benefits clearly outweigh the risks (in the short term, at least).  
 
In Australia, however, where community spread is sporadic and only small numbers affected, the way forward is not so clear. 
 
While we wait for data to come in about the true risks and side effects from each vaccine, there is a growing body of vaccine misinformation, largely based on case studies and theories, filling the information void. This is often spreading via social media and is packaged as factual information that is (for a variety of reasons) being ‘hidden’ from the general public.
 
This makes it very difficult for GPs to navigate vaccination conversations with our patients and colleagues.
 
While it’s tempting to dismiss anti-vaccination stances as ‘misinformed’ and ‘fear-mongering’, there are a large number of genuinely concerned people who want to know the truth about what a vaccine will actually do to them and for them.
 
The trouble is that GPs don’t want to fabricate confidence or overstate efficacy – that’s not what we do. So in contrast to the supposed clarity of anti-vaccination messages, our voices can sound uncertain and anaemic.  
 
Anyone who says with certainty that they know the risks, benefits and side effects of each vaccine is lying. But because humans have a tendency to want certainty, they will listen to voices that sound confident, even if that confidence is based on opinion rather than evidence.
 
I believe we as GPs owe it to our community to be honest about what we don’t know, while calling out those who pretend do know.  
 
At the moment I believe the clear message to Australians is as follows:
 
COVID-19 vaccines are going to be an important part of combating the virus worldwide.
 
In Australia we have the luxury of watching what is happening in other parts of the world, and by the time we get a chance to choose or refuse a vaccine we will be doing so with clearer evidence of the pros and cons.
 
Anyone who is telling you that they are dangerous is doing so based on their opinion and not on evidence. While they may truly believe it, it’s possible to be truly wrong.
 
Please don’t close your minds off to vaccines until we have more evidence. 
 
I hope GPs respect the trust our community has in us and closely watch the evidence that emerges. In the meantime, we should listen compassionately to our patients’ concerns.
 
In the case of misinformation, we can gently challenge them to reconsider whether what they have seen is actually true (a good strategy is to ask them why they prefer to believe that source over and above all others). No need to change their minds immediately.
 
In the case of uncertainty, I believe we need to be transparent about this, but reassure patients that we will keep them informed once we do have more evidence. This models to them the ability to live with uncertainty without giving into fear.
 
Hopefully by the time vaccines are more widely available we will have laid the path for their acceptance, if the benefits do end up outweighing the risks. 
 
Log in below to join the conversation.

COVID-19 hesitancy vaccine