Tips for responding to vaccine hesitancy

Since the beginning of the COVID‐19 pandemic, we have all been challenged by how to respond to the new world, and what this means for our situation at work, for our families and for those that we are assisting to move through this new and constantly changing space. There have been times when many of the decisions have been taken out of our hands, and our ability to respond to this situation has been more of how do we incorporate these decisions into our lives, rather than what decisions do we make. This challenge has been huge in the family space and often overwhelming. How do we manage this new world and manage safety concerns as well as ongoing relationships with our children and older members of our family in particular? How do we maintain our sense of autonomy and proper decision-making for those that we are responsible for?

Our world has shifted again, and most of the decisions for the safety of us and those around us, are no longer imposed upon us, and are now back within our control. However the mixed messages, and the inconsistencies with what we have been told over the last few years make this a very confusing and uncertain space! Do we wear masks, do we go back to all of our previous activities that bring us into close contact with many others whose Covid management we are unaware of, do we continue to get vaccinations and boosters?

Our  work in the family disputes space has placed the issue of vaccine hesitancy front and centre. Decisions about vaccination for children have become a contentious issue within many families, in some cases requiring the family court system to settle a dispute about child vaccination when parents cannot agree. There is an important need to understand parental vaccine hesitancy and the best strategies for addressing it in practice. These ten tips provide some ideas for understanding and responding to parental vaccine hesitancy.  

1. Understand that vaccine hesitancy exists on a spectrum. Attitudes towards vaccination vary from those who have the most accepting views towards vaccination on the one hand, to those who are most resistant to vaccination on the other. The vast majority of parents appear to fall somewhere in the middle. Some parents consent to some vaccines for their children but not others, but few parents refuse all vaccines. It is important to understand that parental attitudes are complex and ever‐changing, so there are countless opportunities to have respectful discussions about this issue with parents.

2. Recognize that parents may feel hesitant for a variety of different reasons. Vaccine hesitancy may be driven by different things for different parents:

• some parents are fearful of newer vaccines,

• some parents are concerned about needle pain,

• other parents wish for their child to acquire natural immunity

• some parents do not see vaccine‐preventable diseases as a significant threat to their child’s life.

Understanding the concerns that are driving vaccine hesitancy is a necessary step in being able to thoughtfully engage with vaccine‐hesitant parents.

3. Respect that vaccine attitudes like many other health attitudes, are often shaped by many factors. Often vaccine hesitancy is influenced by factors at a variety of levels from the immediate family system all the way up to government policy. Social forces play an especially important role in vaccine decision‐making and parents tend to be impacted by perceived social norms related to vaccination in both real life and virtual communities.

4. Notice how previous healthcare experiences may impact vaccine hesitancy. In some cases, past negative experiences with the healthcare system can impact parents’ attitudes towards vaccination. For instance, if parents felt that in the past their child’s vaccination pain was not properly managed or if they did not feel heard in a clinical interaction, they may be more apprehensive to attend further vaccination appointments.

5. Appreciate the historical roots of medical mistrust among minority populations. For some communities, a history of mistreatment by the healthcare system has created community‐wide feelings of medical mistrust. Often these deeply rooted feelings are challenging to address and can only be solved with the slow rebuilding of trusting relationships between the healthcare system and marginalized communities.

6. Use open‐ended questions to try to uncover parents’ concerns about vaccination to best understand parents’ concerns and give parents the chance to share their perspectives. Generally, parents want to be heard and understood.

7. Remember that parents have their children’s best interests in mind. Vaccination has become a hugely contentious topic and it is easy to forget that parents’ attitudes are often coming from a place of concern for their children’s well‐being. Over the course of vaccination discussions, it can be helpful to remind parents that you recognize this. This will go a long way towards building engagement with parents.

8. Utilize reflective listening to help parents explain their perspectives, and to be able to understand their concerns and rationale. This is often a helpful way to build engagement and to clarify the specific concerns parents have, and you can then more easily then move on to engaging in a discussion based on evidence-based information.

9. Consider the ‘ruler method’ a useful tool for talking about vaccine attitudes, to help parents see their existing confidence with vaccination and opportunities to build on it (e.g., On a scale from 1 to 10 how confident do you feel about vaccination for your child? [If they answer 4] Why did you say a 4 and not a 2?), and to understand the most important factors holding parents back from consenting to vaccination (e.g., On a scale from 1 to 10 how likely is it that you will have your child vaccinated this year? [If they answer 4] What do you think it will take to get you from a 4 to a 6?)

10. Be aware of how access barriers may impact vaccine hesitancy. Access barriers such as cost, transportation, work hours, childcare etc. may impact upon vaccine hesitancy and be a leading or contributing factor preventing children from receiving some or all vaccines in a series. Connecting parents with appropriate community supports which can ameliorate these logistical concerns is an effective means of enhancing vaccine uptake.

If you would like to explore any of these issues contact us at Creative Family Law Solutions- we would appreciate the opportunity to connect with you!

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