草莓污视频导航

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May 14, 2021

How better conversations can help reduce vaccine hesitancy for COVID-19 and other shots

Empathetically exploring the positive motivations of people who are vaccine hesitant may help improve acceptance for COVID-19 vaccines and others, writes Myles Leslie, School of Public Policy, in Conversation Canada

New parents have many decisions to make soon after their baby is born. One of them is about vaccination.

Between the cooing and crying, cards and bouquets, and yet another change of clothes, parents will be asked about inoculating their infant against childhood illnesses. Where once the answer would have been 鈥測es鈥 by default, the past few decades .

Vaccine hesitancy

While vaccination remains the norm, for a range of reasons exhausted mothers and nervous fathers are saying 鈥淲e鈥檒l wait鈥 or even 鈥淣o鈥 to vaccinations in maternity wards across the country.

In an era of patient-centrism and individual autonomy, the parents鈥 right to hesitate is accepted. But health-care professionals are often worried by both the individual risks and societal consequences of the choices that are being made. Life threatening and altering diseases   鈥 once eradicated or marginalized by vaccines 鈥 are creeping back.

While vaccination remains the norm for babies and children, some parents have become more hesitant about vaccines.

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Canadians鈥 attitudes towards COVID-19 vaccines suggest hesitancy and its societal consequences are not limited to the choices of newly minted parents. Recent surveys , , show many of us are hesitant about vaccines that have been produced with such herculean effort and enormous cost. So many, in fact, that the immunization thresholds required to tame COVID-19 are under threat.

This hesitancy has been described , and linked to , past  and attitudes towards .

However, just what to do about it has been less clear. While most Canadians will say yes to COVID-19 vaccines, many of us also know a friend or a family member who is, at least for the moment, saying no.

Most of us know someone who mistrusts some element of the vaccine 鈥 from the speed of its production, to the intentions of its manufacturers or deliverers. Indeed, COVID-19 vaccine hesitancy is said to be on the rise, nudged upwards by the various . How, under these conditions, might we turn a 鈥渘o鈥 into a 鈥渕aybe,鈥 or even a 鈥測es?鈥

Motivational interviewing

My research team at the 草莓污视频导航鈥檚 School of Public Policy started our most recent work with just this question in mind. It turns out the answer was just a few provinces away in Qu茅bec, and took us back to newborns and their parents.

We have been working with Canadian federal and World Health Organization funding to support family doctors as they respond to the pandemic. To support better conversations about vaccine hesitancy, we met with Dr. Arnaud Gagneur, a hospital-based neo-natalogist in Sherbrooke. He and his colleagues are world leaders in improving dialogue around vaccination with new parents.

Family doctors are well positioned to have productive conversations with patients about vaccination, including COVID-19 vaccination.

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The technique they鈥檝e been working with for more than a decade is called motivational interviewing and it has shown great success.

Described in  and , a motivational interview is based on a seemingly simple idea: find a vaccine-hesitant person鈥檚 positive motivation. The art of accomplishing this lies in long and empathetic engagement with the person to get to the roots of their hesitancy.

Those roots will often be negatively expressed: 鈥淚 don鈥檛 like the way it was made,鈥 or 鈥淚t鈥檚 a conspiracy, you know.鈥 Under the principles of motivational interviewing, these roots are to be respected and acknowledged, regardless of how gnarled they might appear. Attempting to chop them off with arguments and facts will only encourage the person to . Unless the person鈥檚 concerns are acknowledged as valid, facts are more likely to hinder than help.

The aim isn鈥檛 to chop off the negative, but rather to have the positive reveal itself. This takes conversation, close listening, empathy and above all, trust. Shifting out of the negative reason and into an expression of a positive aspiration is something that takes time, not argument. This, in motivational interviewing, is the key to moving from 鈥淚鈥檓 religiously opposed to the vaccine,鈥 to helping someone understand that vaccination may allow them to attend worship again soon.

Progress in primary care

Our team was originally dismayed by this. Of course it worked for Dr. Gagneur and his team, but they have huge blocks of time to talk to new parents about their hesitancy. Neither all that time, nor the intensity of a recent birth, are common features of family medicine as practised in Canada. Could the principles of motivational interviewing be distilled into the short encounters of most primary care visits?

We were encouraged to seek an answer because family doctors have  and  to deal with COVID-19 and its . They have also been identified as  in countering vaccine hesitancy. This is because they have the long-term relationships with patients who trust them, and the space to understand and validate the concerns those patients raise.

Where many people might struggle to find the positive motivation in a friend or family member鈥檚 hesitancy, a family doctor is better positioned to do so. With this in mind, our team has been working with doctors from across Canada to develop a pragmatic tool to help them navigate tricky conversations with people considering COVID-19 vaccines, or with parents making decisions about their children.

The tool will be web-based and stocked with helpful examples. Along with the family doctors who have been so generous with their time in developing the tool, we are hoping it will contribute to better conversations about vaccine hesitancy.

is associate professor, School of Public Policy.