Vaccination: Understand at individual level, debate at group level…

case studySir Leszek Borysiewicz, chief executive of the Medical Research Council, is reported in The Times (10 June 2010) as saying doctors and nurses must take greater responsibility both for educating the public about vaccine benefits and for exploring any objections. In his view public health strategists rely too heavily when responding to concerns on ‘big sign solutions’ such as comprehensive studies and analyses.

“We need to train a whole cadre of health professionals to be able to address at an individual level people’s concerns and fears …. It’s about getting to that point where you are asking: ‘What is it that you are really worried about? Let me try to understand where you are coming from as an individual’…. For most people it goes back to the primeval: ‘Well my mother had measles, I had measles, so why do I need to take the risk [of vaccinating my child]?’ What they are really saying is, ‘Can I live with myself if something went wrong?’ ”

Indeed – though one might also ponder here whether sometimes people simply seek a rationale to avoid the unpleasantness of having the jab?

And the messages are mixed even amongst those professionals who we expected understand the arguments. Apparently in the winter of 2009/10 around 40% of midwives advised pregnant women (known to be at high risk if not immunised) against having the swine flu vaccine; and – incredibly? – fewer than 1 in 7 front-line NHS staff themselves have the seasonal flu vaccine.

Prof Borysiewicz said that medicine had been caught flatfooted repeatedly by a failure to prepare for opposition to vaccination, from swine flu and MMR now, back as far as smallpox in the 1860s.

“With every vaccine story we go through, we act as if we are surprised that somebody is actually opposed to it….. You don’t address [concerns] by trying to rubbish the people who are coming up with these views. You have to try to understand them at an individual level and then be prepared to debate them at a wider group level.”

So here’s a compelling case for the million small conversations. Who then will the proposed ‘cadre of health professionals able to address at an individual level people’s concerns and fears’ be?
And how / by whom will they be trained, in what contexts and in what specific skills?

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Posted on June 10, 2010, in Real-Life Examples and tagged , , , , , , . Bookmark the permalink. Leave a comment.

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