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Vaccine safety in the next decade: Why we need new modes of trust building?
Heidi Larson, PhDProfessor of Anthropology, Risk and Decision Science
Director, Vaccine Confidence Project3 December 2019
The team at The Vaccine Confidence Project conducts global research on vaccine confidence, examining local and global dynamics which influence vaccine decision-making.
2
Confidence in products
Confidence in providers
Confidence in policy makers and systems
The Vaccine Confidence Project
Survey by American Society for Microbiology and Research America
https://www.google.com/search?q=public+trust+vaccine+safety&rlz=1C1GCEB_enGB836GB836&oq=public+trus&aqs=chrome.0.69i59j0l2j69i57j0j69i61j69i60j69i61.4460j0j7&sourceid=chrome&ie=UTF-8
Confidence in SAFETY
https://www.theguardian.com/society/2019/jun/19/survey-shows-crisis-of-confidence-in-vaccines-in-parts-of-europe
MAP: http://www.lemonde.fr/sante/article/2016/09/09/plus-de-quatre-francais-sur-dix-estiment-que-les-vaccins-ne-sont-pas-surs_4994856_1651302.html
Strongly disagree
agree
“Vaccines are safe?”
State of Vaccine Confidence 2016Larson et al. EBioMedicine 12 (2016) 295–301
5555
6666
7777
88
99
111111
1212
152020
2124
3132
3651
107
0 20 40 60 80 100 120
Immune system too weakConflicting messages
Negative experience (personal)Too many vaccinesNever had/get VPD
Mistrust doctorsConcerns about injections
Promiscuity, STI vaccineVPD have benefits
Influenced by family/friendsMistrust governments
Vaccine cause the disease they preventMistrust health authorities
Mistrust pharmaceutical companiesNatural alternatives
Against vaccination in generalNegative media reports
Not priorityRisks > benefits
Too youngVaccines too new
Do not qualifyStrong immune system
Not offered, recommended againstNot enough evidence, testing
Vaccines not necessaryLack information, misunderstandings
Vaccines don't workVPD not severe
Low risk of contracting VPDVaccine safety
Low risk of contracting VPDs
Fear of side effectsVPDs not
severe
What drives low confidence in Europe?
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Frequency of concerns: number of qualitative studies where concerns were mentioned + number of quantitative studies where more than 20% of participants mentioned those concerns
Karafillakis & Larson (2015). Analysis of public concerns and perceptions related to benefits and risks of vaccines. ADVANCE D1.4 Report
GPs vaccine recommendations
Diagnosis:HIGH VOLATILITY
Total percentage of safety-related concerns: 62%
CONFIDENCE IN SAFETY PROCESSES
9-Jan-20 [email protected]
Media analysis around rumors which prompted Ebola vaccine trial suspension in Ghana (2015)
WHEN ITS NOT MISINFORMATION,BUT SEEDING DOUBT
ROMANIA 2017http://www.feedler.ro/feed/7208497--cluj-reactie-raed-arafat-despre-panourile-antivaccin-uitati-va-la-ce-s-a-intamplat-cu-copiii-afectati-de-rujeola-lipsa-vaccinarii-a-fost
“Vaccines are NOT safe!...Know the risks!”
ITALY 2018
New Zealand [email protected]
Instilling doubts, amplifying risks
Aluminum, mercury and other “toxic”ingredients
WHEN ITS NOT THE VACCINE,BUT THE VACCINATION EXPERIENCE
DENMARK
IRELAND
COLOMBIA
“We may be witnessing a milestone in the history of MPI (mass psychogenic illness)
where the primary agent of spread will be the Internet and social media networks
Bartholomew RE et al. Mass psychogenic illness and the social network: is it changing the pattern of outbreaks? J R Soc Med. 2012 Dec; 105(12): 509–512.
When its not about the vaccine,but the vaccinationexperience
When its not about the vaccine,but the vaccinationexperience
WHEN THE SIGNALS ARE FABRICATED(Yet still provoke panic)
1894
“Fake news” has also been here before
[email protected] Neil Johnson/GWU
This is a dynamic, fast moving landscape
“communications on steroids”
Risk as feelings (fast , instinctive, emotional.. )
Risk as analysis (logic, reason, scientific...)
Risk as Politics
Slovic et al. Risk Analysis 2004; 24 (2): [email protected]
Looking Forward
Evidence is there, but still questioned
New questions, need more evidence
Good communication needs good science (although its not enough)
Marketing strategies can be helpful BUT need caution – those in the advertising business may not appreciate the risks of over-promotion
Looking Forward (2)
Context, context, context: Local and global (“risk/benefit depends on where you live”)This is about politics, geo-politics, development and a hyper-connected, anxious populations
(“bartering vaccination for electricity”)
Be careful with what we promise….
www.vaccineconfidence.org