In 2019, the World Health Organization identified vaccine hesitancy as one of the top ten threats to global health. Search the literature about the epidemiology of vaccine hesitancy and some of the possible proposed solutions. 

Consider how you might address this issue in your own practice areas in your initial post and responses to your classmates.  

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Post your initial response by Wednesday at 11:59 PM EST. Respond to two students by Saturday at 11:59 PM EST. The initial discussion post and discussion responses occur on three different calendar days of each electronic week. All responses should be a minimum of 300 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and referenced.  A minimum of 2 references are required (other than the course textbook). These are not the complete guidelines for participating in discussions. Please refer to the Grading Rubric for Online Discussion found in the Course Resources module. 

Thank you, Everyone, for a great discussion this week! You all did a great job in demonstrating why some people find it difficult to believe the science of vaccination. You noted the distrust sowed by unethical studies like Tuskegee or headline-grabbing research reports later found to be the result of poor research practices that negate the findings. It is our job, as healthcare professionals, to educate our patients with strong evidence that supports vaccination while being honest about some of the risks. In an interesting commentary, Kantor (2020) compared Covid vaccine hesitancy to the failure of many people to use sunscreen even though the benefits are well known and suggests the problem is more than just a knowledge deficit. The author suggests the problem may also be that the outcome to be avoided is often far removed from the preventative action (sunscreen use or vaccination) or believed to be unlikely. We will be discussing the health belief model later in the course which also supports the idea we need to look at health prevention more broadly to determine how to best influence healthy behaviors.

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                                                                                                           Reference

Kantor J. (2020). Behavioral epidemiology: Vaccine hesitancy, sunscreen hesitancy, and smoking cessation. Journal of the American Academy of Dermatology International, 1(2), 222–223. https://doi.org/10.1016/j.jdin.2020.10.008

I was called by the team to go assess a patient who was complaining of increased SOB and nonproductive cough x1 week. It was the first week of January and a time were multiple respiratory infections were adamant due to the recent holiday season and many social gatherings, the latter, a great medium for the propagation of those infections. The patient had COPD and chronic respiratory failure on home Oxygen. She was hemodynamically stable moreover, she tested positive for Covid 19. The patient had always refused the COVID vaccine despite her pulmonary status.

I can never forget the fear on her face when she was made aware of her positive status.

Vaccine hesitancy is when one is late in accepting or refuses vaccination when the latter is available, supplied and the person made aware (CDC,2023)

Misleading information in different media platforms has recently been the main fuel in increasing the probability that a person will fall under this group (Larson et al., 2022)

Also, a surge in people with vaccine hesitancy is noted whenever new information about the vaccine is made public, new risks are disclosed or new policies are created (Larson et al., 2022)

Decreasing trust in experts, availability and polarization towards alternative health, political bias and belief structure all play a role in vaccine hesitancy. Larson et al., 2022)

The issue of vaccine hesitancy is not new , moreover It has been escalated out of proportion by the internet.

We could cite the information on You Tube and the drop in MMR vaccine. A study showed that negative You tube Videos outnumbered pro vaccine videos by 1-3. The anti-vaccine videos were more viewed compared to the pro- vaccine videos. (Larson et al., 2022)

The shift from decreasing the rate of infection to eradication is also a notion to be mentioned.

For instance, in 1945 a 75% Diphtheria vaccination rate was a miracle as the aim is to control the disease does not eradicate.

A number 95% or above is needed to get to herd immunity and work towards the eradication of the latter. (Vaccine Hesitancy Is a 21st-Century Phenomenon | Perspectives on History | AHA, n.d.)

Coming now to possible solutions to the problem, the same social media platform could be used to conduct surveys. Despite the population in those platforms not being randomized, studies have showed that the data coincide to that of randomized surveys Larson et al., 2022). Areas shown by the survey which carry the most hesitancy are hence given more priorities by outreach program to influence the latter toward being vaccinated. Larson et al., 2022)

Also, the period of hesitance is also the best time to convince a person to get the vaccinated Larson et al., 2022)

Microtargeting communities where the problem persists and educating via outreach programs is the primordial way of influencing more people to come to vaccination sites Larson et al., 2022)

References

Calgary, O. (2021). Vaccine Hesitancy for COVID-19. Data.cdc.gov.

‌

Larson, H. J., Gakidou, E., & Murray, C. J. L. (2022). The Vaccine-Hesitant

Moment. New England Journal of Medicine. https://doi.org/10.1056/nejmra2106441

Vaccine Hesitancy Is a 21st-Century Phenomenon | Perspectives on History |

AHA. (n.d.). 

Www.historians.org.

In addition to caring for patients, healthcare providers must advocate for and protect the community and public health. One way the provider can help support the community s to provide required immunizations per CDC requirements and age. Nuwarda et al. (2022) report that vaccinations are best known for eradicating diseases such as “rubella and polio.”  However, while these vaccinations help prevent infection, some patients are hesitant to receive vaccines for many reasons, including possible anxiety, misinformation from a non-reputable source, and cultural or religious practices (Nuwarda et al., 2022).

  Vaccine hesitancy can have a severe impact on patients and the community. Nurwarda et al. (2022) pointed out that vaccine hesitancy is known to be one of the most severe threats to global health. According to Nurwada et al. (2022), one primary concern in patients with vaccine hesitancy is that these patients do not have herd immunity. Herd immunity is defined as a population of patients who are protected from disease by immunity (Merrill, 2021). The epidemiological process behind herd immunity is that if there is low herd immunity within the population, the unvaccinated patients will then act as a reservoir, leading to an outbreak of the virus (Nurawda et al., 2022).

  In my practice as a nursing instructor, I don’t see many vaccine-hesitant patients; however, like many schools of nursing require the covid vaccinations, a couple of my students initially were hesitant and did not believe in the vaccine. As per my DON, I was to address this with my students and investigate their reasoning as to why they did not want the vaccine. Since I have been the student’s instructor for almost two years, I have developed a trusting relationship with them. In addition, while talking with the students, I provided the necessary resources and the most up-to-date research regarding the vaccine so they could reference it if needed.  Dubey (2019) reports that when talking to patients, healthcare providers should continuously develop a trusting relationship

            While in practice, the first approach I would take is to develop that sense of trust with the patient and be honest and open about vaccination schedules and the purpose, as well as if any side effects may occur. Dubey (2019) identifies categories in which vaccine hesitancy appears, including a lack of confidence, complacency, and lack of convenience. For example, lack of confidence indicates the person may not be sure of the vaccine’s safety or may not feel confident with adhering to the law and requirements. Secondly, complacency suggests the patient may have a low risk of developing infections. Third, lack of convenience indicates that the patient may not have access to immunizations such as a Doctor’s office or clinic (Dubey, 2019).

In my practice, I would take the following steps to help people understand that vaccinations are helpful and not harmful. Dubey (2019) identify methods to use when approaching the patient about vaccinations. These methods include coming to the parent or patient with a presumptive approach. For example, I would inform the patient or parent that they are due for the recommended vaccines today. I would also describe the benefits, such as vaccinations keeping us healthy; for example, the patient should be told that vaccines do work and that receiving the immunization can prevent severe disease. Lastly, in answering the questions about side effects, it is essential, to be honest, and open; with this in mind, the patient should be told that there are minimal side effects, and they are treatable (Dubey, 2019).

In conclusion, providing education about vaccinations will hopefully eradicate any negative thoughts about receiving them. Patients should also be told that immunizations are safe and that a disease becomes less prevalent in getting vaccinated, therefore keeping the patient, family, and loved ones safe (Dubey, 2019).

                                                References

Dubey, V. (2019). Addressing vaccine hesitancy: Clinical guidance for primary care physicians working with parents. Canadian Family Physician, 65(3), 175-181. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515949/

Merrill, R.M. (2021). Practical disease concepts in epidemiology In R.M. Merrill (Eds) Introduction to Epidemiology. (9^th ed, pp.39-71) Jones and Bartlett Learning.

Nuwarda, R. F., Ramzan, I., Weekes, L., & Kayser, V. (2022). Vaccine hesitancy: Contemporary issues and historical background. Vaccines, 10(10). https://doi.org/10.3390/vaccines10101595