Childhood immunisation has been one of the last century’s most successful public health measures. Yet, for some, vaccination remains a highly politicised and contentious issue. Naturopath, academic and former nurse Jon Wardle reveals how his latest research project is set to bridge the gap between childhood vaccination and the vaccine hesitant.
Vaccine hesitancy is an emerging public health problem. Though the high rate of childhood vaccination coverage in most high-income countries indicates that paediatric vaccination remains a widely accepted public health measure, support for paediatric vaccination is not universal.
The problem with this is that even relatively small levels of non-vaccination can affect ‘herd immunity’. Immunisation rates of up to 95 per cent are required to prevent the spread of infectious disease within a community and protect against outbreaks.
What this means is that even a small minority of parents choosing not to vaccinate their children can have a significant impact on the emergence of childhood infectious disease. For example, in the last six months we’ve seen measles outbreaks in Sydney, Perth and Adelaide. They come just two years after the World Health Organization declared the elimination of measles in Australia and show the dangers of complacency.
However, very few people are truly ‘anti-vaccine’ – only around 1.5 per cent of the population. It’s a number that has remained consistent since Federation, but the reasons for opposition have changed.
public health has a tremendous product to sell; it’s just sometimes very bad at selling it
In fact, the largest group of Australians that don’t vaccinate aren’t necessarily against vaccines, but are often sitting on the fence of the issue. Many of these parents have valid concerns and questions around vaccination. However, the emotive, highly politicised and inflammatory rhetoric means they either don’t raise their concerns with their healthcare provider or they’re not given the chance to ask at all.
These are the parents who often get pushed to alternative sources of information.
Both groups are right to be frustrated. Parents should have questions about vaccination; they should have questions about everything that involves their children. They’re ultimately quite selfish when it comes to their children. That’s what makes them parents; it’s evolutionarily built in.
Similarly, health professionals and vaccination advocates are right to be frustrated at parents not immediately seeing the obvious and apparent benefits of vaccination. The benefits are extraordinary compared to the very minor risks – the most dangerous part of vaccinating your child is driving to the appointment.
The problem is these two groups are not speaking the same language. Health professionals and vaccination advocates are making their case using data, facts and figures. But parents don’t think like that. When it comes to their children, parents think emotionally. You can’t engage with them by just throwing numbers at them.
Unfortunately, alternative information sources promoting misleading anti-vaccination material are much better at this emotional engagement than health practitioners or public health agencies. This starts from the very first contact (‘We understand you have questions …’).
Conversely, many public health and medical professionals can come across as dismissive of parents’ concerns.
Indeed, last year, our research of ‘attachment’ parents (those who espouse natural principles and philosophies towards child health) found that unwillingness or inability of conventional health providers, like doctors and nurses, to answer questions was often a driver for non-vaccination.
Vaccination itself aligns with many natural health approaches
My latest research aims to identify ways to better tailor vaccination messages to specific audiences who are known to have high levels of vaccine hesitancy and to develop resources to help health professionals better communicate with parents about their concerns. Already, it appears, much of this could be adequately addressed through better, respectful, empathic communication.
For example, research from the Australian Research Centre in Complementary and Integrative Medicine at UTS suggests that although users of complementary medicine tend to be vaccine hesitant, most complementary medicine practitioners are actually supportive of vaccination.
Vaccination itself aligns with many natural health approaches – it’s low dose, preventive, and encourages the body’s own healing processes through the development of natural immunity.
I myself was a naturopathic practitioner and teacher and met many patients and students who wanted to vaccinate their children. But they thought they couldn’t if they wanted to have a natural approach to health.
In fact, most vaccine literature is aimed at a low health-literate audience, but those who are vaccine-hesitant are often better educated than the general population and demand more detailed and highly technical sources of information. If public health advocates won’t provide them, it is a gap that will be (and has been) readily filled by those with an anti-vaccination agenda.
The case for vaccination is as overwhelming as the arguments against it are underwhelming. What is truly extraordinary is that public health has a tremendous product to sell; it’s just sometimes very bad at selling it. Hopefully my work can make that sales job a little easier.