A GUIDE TO VACCINE CONFIDENCE

Transcription

1 1 A GUIDE TO VACCINE CONFIDENCE Rebecca Vanucci Immunization Outreach Coordinator Massachusetts Department of Public Health October 12,

2 2 Disclosure I, Rebecca Vanucci, have been asked to disclose any significant relationships with commercial entities that are either providing financial support for this program or whose products or services are mentioned during my presentations. I have no relationships to disclose. I may discuss the use of vaccines in a manner not approved by the U.S. Food and Drug Administration. But in accordance with ACIP recommendations. 2

3 3 Outline Background on Vaccine Confidence Specific strategies to instill, build, and maintain vaccine confidence Recent articles on public health and economic impact MDPH Health Communication Campaigns Resources (websites, toolkits, courses) 3

4 4 Vaccine Confidence Choice of term vaccine confidence instead of vaccine hesitancy Confidence amount/level of trust In the recommended immunizations In the provider(s) who administer vaccines In the process that leads to vaccine licensure and the recommended vaccination schedule More confident = less hesitant National Vaccine Advisory Committee, Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee, December Report found at: 4

5 5 Vaccine Confidence used to look a lot like this 5

6 But recently, we have seen some shifting 6 6

7 7 So, what s happening? Disease outbreaks Pertussis Measles Mumps More, different vaccine voices Parent advocacy groups in favor of vaccines Social Media platform Andrew Wakefield 1998 MMR-Autism Study discredited Fully retracted and he lost his medical license Only looked at kids displaying signs of autism More than 20 studies after looked at the connection and showed no link between MMR and autism 7

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9 Immunization A Complex Communication Environment 9 Low disease awareness = increased focus on vaccine risks Low tolerance for vaccine risks Full and complicated immunization schedule Time is often limited Many places to find and get information 1 Brunson EK. The impact of social networks on parents' vaccination decisions. Pediatrics. 2013;131(5):e Smith PJ, Kennedy AM, Wooten K, Gust DA, Pickering LK. Association between health care providers' influence on parents who have concerns about vaccine safety and vaccination coverage. Pediatrics. 2006;118(5):e

10 10 Research shows parents are confident in The safety of vaccines The effectiveness of vaccines The benefits of vaccines The number of vaccines their child gets in the first 2 years of life 10

11 But they still might be anxious about the shot visit 11 About 25% of parents report having at least a little anxiety They may still have questions 11

12 12 Common Patterns Feeling a lack of control or needing to be in control of health outcomes A negative healthcare experience in the past Buying into a particular parenting style Distrust of government or corporations Flawed risk assessment involving vaccines and diseases Chemophobia 12

13 13 Steps to Increase Vaccine Confidence Know the credible sources of information Research commonly asked questions about vaccines Understand the motivating factor for the parent s hesitancy Be respectful and listen to their concerns Share your reason for vaccinating Continue the conversation Ones-Toolkit.pdf 13

14 14 VaxNorthwest s Ask, Acknowledge, and Advise 14

15 CASE Method Autism Science Foundation Corroborate: Acknowledge the parents concern and find some point on which you can agree. Set the tone for a respectful, successful talk. 15 About Me: Describe what you have done to build your knowledge base and expertise Science: Describe what the science says Explain/Advise: Give your advice to patient, based on the science 15

16 16 CASE Vaccines and Autism Corroborate: There s certainly been a lot of coverage on television about vaccines and autism so I can understand why you have questions About Me: I always want to make sure I m up to date on the latest information so that I can do what s best for my patients, so I ve researched this thoroughly. In fact, I just returned from a professional conference Science: The scientific evidence does not support a causal link. The CDC, the AAP, the NIH, the IOM (etc) all reviewed the data and all reached the same conclusion. Dozens of studies have been done. None show a link. In fact, the latest autism science indicates Explain: Vaccines are critical to maintaining health and wellbeing. They prevent diseases that cause real harm. Choosing not to vaccinate does not protect children for autism, but does leave them open to diseases. Kids need these vaccines. Some content taken from Autism Science Foundation s Autism 101 Webinar for the MCAAP Immunization Initiative, December

17 17 CASE Diseases aren t so bad Corroborate: I can understand why you might feel that way. Hey, I had chickenpox myself. About Me: The vaccine program has been so successful and a lot of the diseases that we feared, like polio, are no longer a concern. Until last year, I had never seen a case of HiB or measles, but now these diseases are making a comeback. At a recent conference I learned about we still have hospitalizations for whooping cough in Massachusetts. In my practice.. Science: These diseases have come back in areas where vaccination rates are low. This year, in Minnesota there was a large outbreak that sickened 79 people and exposed over 8,000. It s estimated to have cost the Minnesota DPH approximately $900,000 for the outbreak response. In 2015, there was even the first U.S. measles death in 12 years. Explain: We care about our patients and don t want to practice substandard care. All our patients need to be vaccinated. My children are fully vaccinated. Some content taken from Autism Science Foundation s Autism 101 Webinar for the MCAAP Immunization Initiative, December

18 18 CASE Too many vaccines Corroborate: Kids today certainly get more shots than kids did years ago. About Me: Our practice follows the CDC and AAP schedule because it is carefully designed to protect children at the time they are most vulnerable to disease. Science: Explain: We want all the kids in our practice to be immunized so that they have the greatest chance for a long, healthy life. My own children are fully vaccinated. Some content taken from Autism Science Foundation s Autism 101 Webinar for the MCAAP Immunization Initiative, December Too Many Vaccines? What you should know (Vaccine Education Center, CHOP) 18

19 19 A few tools continued Talk about individual benefit List the benefits to the community By following the immunization schedule, your Show the risks of vaccinepreventable but protects disease those who are too child will Vaccinating have protection your child not only against protects 14 serious her from vaccine- serious diseases, little rash. young preventable diseases by age to be 2. vaccinated or people with weakened immune systems and the elderly, who are at risk for serious complications and death. The success of vaccines means that we don t see a lot of vaccinepreventable diseases anymore, but we have to remember they are very serious. For example, did you know that before the measles vaccine was introduced, there were 3-4 million cases a year, recommended childhood 48,000 people were hospitalized and people died? Measles is highly contagious and not just a 19

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23 Using school data to address vaccine confidence Look up your school s immunization rates 23 Fortunate to live in an area of high imm. rates However, there can still be pockets of un or underimmunized children Need to keep high rates to protect kids Be an advocate! Our area may be susceptible to VPD and outbreaks Important to vaccinate your child on rec d immunization schedule Please tell your friends Be an advocate! 23

24 24 Public Health and Economic Impact a 5% decline in MMR vaccine coverage in the United States would result in an estimated 3-fold increase in measles cases for children aged 2 to 11 years nationally every year, with an additional $2.1 million in public sector costs. The study only accounted for children 2 to 11 years of age. The public health and economic numbers would be much higher if unvaccinated babies, adolescents, and adults were included. This article highlights that even small reductions in vaccination coverage can have significant implications for public health and associated costs. A recent study estimated that the cost to public health of a measles outbreak is between $13,326 and $33,316 per case. Direct medical costs range between $92 and $553 for outpatient visit and $4,236 and $48,492 for hospitalization. JAMA Pediatrics, Public Health and Economic Consequences of Vaccine Hesitancy for Measles in the United States ( Acad Pediatr. Impact of Nonmedical Vaccine Exemption Policies on the Health and Economic Burden of Measles ( 24

25 25 FRED Simulator Great tool to show how outbreaks occur in areas with different vaccination coverage. 25

26 26 Course made by Within Reach Presented by: Dr. Edgar K. Marcuse, MD, MPH, FPIDS Emeritus Professor, Pediatrics University of Washington Register at: 26

27 27 Mass Public Health Blog 27

28 28 MDPH Twitter Tweets throughout our immunization campaigns and all of flu season National Infant Immunization Week (April) National Immunization Awareness Month (August) National Influenza Vaccination Week (December) Follow us at: /massdph 28

29 29 Good resources for parents Vaccine Education Center s handouts for parents and patients resources/vaccine-and-vaccine-safety-related-qa-sheets Every Child By Two s websites: and CDC s Parents Guide to Childhood Immunization CDC s facts sheets on vaccine-preventable diseases for parents index.html IAC s handouts for communicating with parents IAC s website for the public 29

30 Every Child By Two s State of the ImmUnion

31 31 Children s Hospital of Philadelphia Vaccine Education Center Vaccine Q & A s Vaccine-safety Q & A s Includes references to studies on the topic 31

32 Parent Friendly Resources

33 Parent Advocacy Groups 33 Dr. Wendy Sue Swanson hildrens.org/ 33

34 34 Take away messages The majority of people vaccinate on the recommended immunization schedule. There is no one size fits all solution to talking with parents. Respectful conversations lay the foundation. 34

35 35 Questions? Rebecca Vanucci Immunization Outreach Coordinator