As the nature of the pandemic changes, so do conversations around vaccine hesitancy

As COVID-19 becomes an endemic disease, a permanent fixture in our population, vaccines against the virus will also likely become a permanent part of life in Canada.

This means that health-care workers will continue having difficult conversations with vaccine-hesitant patients, say the University of Calgary researchers behind an online tool designed to help shape discussion around vaccines, adding that this hesitancy, or outright refusal, has been most prominently on display in recent blockades and convoys and in the low child vaccination rates found across the country.

These examples suggest the challenge of convincing people to be vaccinated will be part of a new normal, say the researchers behind the Vaccine Hesitancy Guide, an online resource that has already been accessed more than 137,000 times, aimed at making those ongoing conversations less difficult and more productive.

Collaborative research

The guide was developed by researchers from the University of Calgary’s School of Public Policy and the O’Brien Institute for Public Health, alongside primary care and specialist physicians to improve conversations with vaccine-hesitant patients. It has recently been updated to address the changing challenges posed by the pandemic, such as providing focused advice for vaccine conversations that involve children, medical exemptions, and pregnancy. 

The aim of the guide, which has already been accessed by more than 20,000 people, isn’t to “stickhandle hesitant people into doing something they don’t want to do,” says lead researcher Dr. Myles Leslie, PhD. Instead, explains Leslie, the guide’s focus is on helping frontline workers create safe spaces for open conversations so that patients can make informed and empowered decisions about vaccination.

“Our team has learned that building and supporting trusting relationships between health-care providers and patients is the most important part of promoting vaccine confidence,” says project lead Dr. Raad Fadaak, PhD.

The researchers point to studies that have shown that the more data and vaccine information given to people who are vaccine hesitant, the more likely they are to entrench themselves in their beliefs. According to Alberta Health figures, approximately 15 per cent of the population are not yet fully vaccinated, a population that is becoming increasingly difficult to reach.

Achieving trust central to honest discussions

“Trust, achieved through mutual respect and concern, is central to creating a space for honest discussion about vaccine fears and concerns,” Fadaak says. "Trust is often more important than the facts and evidence vaccine counsellors and hesitant patients bring to these emotionally charged conversations.”

The guide brings a fresh approach to vaccine hesitancy conversations. It is built on the idea that engagement and “honest, open exchanges are more likely to achieve an informed decision than just merely sharing accurate and complete information,” says Nicole Pinto, project co-ordinator and health policy research associate. 

When frontline health-care workers are able to have open, non-judgmental conversations in which their patients can discuss their fears and concerns, there is a better chance that hesitancy will turn into confidence, according to the researchers, who also admit that this approach is not without its difficulties.

Constant revisions and updates

“One of the biggest challenges has been for counsellors to come up with clear, consistent messaging because of the rapid changes in public policy and the virus itself,” says Fadaak, adding that a full French version is currently in development and will soon be available to the public.

“Our team has been constantly revising and updating the guide to improve its functionality and relevance for vaccine counsellors, as the pandemic evolves,” says Pinto.

Feedback is critical to the evolutionary nature of the guide, says Pinto, who along with her colleagues is asking users to provide their feedback here.

As society starts to accept that COVID-19 — which as of February has claimed nearly 4,000 lives in Alberta and almost six million worldwide — may become endemic, the team behind the guide say those conversations will be critical in dictating what our new future will look like.

“The pandemic has created instability and uncertainty in all of our lives … COVID-19 and its vaccines have changed the conversation,” says Leslie.

The Vaccine Hesitancy Guide is available here.