In order for the campaign to be effective, it is essential that the public health workforce knows the facts. Utilizing the data gathered from our website research of popular anti-vaccine websites and chatrooms, targeted fact-pages will be created for distribution amongst healthcare providers. These one-page flyers or fact sheets will be printed on laminated paper so as to last longer, but will contain the popular myths and rumors used in the Anti-vaccine websites and provide effective messages to respectfully counter their arguments. In addition to fact sheets, we will have targeted trainings of 1 hour ‘working-lunch’ sessions in which a bagged lunch will be provided while trainings are conducted.

 

Specific learning objectives of the training sessions include:

1. Definitions of common vaccine terms: Public Health Professionals (PHPs) should be able to define and explain common terminology such as: immunizations, antigens, attenuated vaccine, booster shots, communicable etc.
2. Safety of Vaccines

• Herd Immunity

1. Altruistic nature of vaccines
2. PHPs should be familiar with at least one case study of a previous antivaxxer getting themselves or child immunized
3. PHPs should be able to talk about the effectiveness of vaccines in a calm, polite manner and be able to provide facts about vaccines and be able to point to reputable resources for more knowledge

Social Media plays a critical role in fueling the anti-vaccination movement though social media messages tend to be about predominantly negative experiences.

Benefits of vaccinations are minimized and focus is on negative experience, fueling public mistrust. Anecdotal stories which have little or no scientific or evidence-based information are driving these online communities. The validity of the stories and credibility of the individuals sharing them typically go unchallenged as they tend to confirm the biases of forum participants visiting anti-vaccine websites.  In a 2004 study in which the beliefs and attitudes of school personnel involved in reviewing student’s immunization status were associated with the vaccination status of children [1], the authors found that nurses were more likely to hold beliefs in support of vaccine safety and effectiveness. They found that misconceptions of vaccines were common and many school personnel were ignorant of the seriousness of some vaccine-preventable diseases and that unimmunized children are highly susceptible to diseases. These misperceptions were associated with an increased likelihood of a child having an exemption to getting required vaccines. The study found that personnel without formal health care training who advise parents on vaccines could be passing on misinformation.

The Public Health Workforce is critical to changing the mindset of anti-vaxxers and some of the tools used in public health communities to counteract the anti-vaccine movement include: statistics and research which are often delivered in the form of CDC Vaccine Information Statements. Another effective strategy is to use the same techniques used by the anti-vaccine movement: storytelling [2]. Giving first-person accounts of positive vaccine experiences or ‘milder’ forms of vaccine-preventable diseases made more manageable because of vaccinations.  Another powerful pro-vaccine narrative is the “anti-vax to pro-vax” conversion in which a parent’s decision not to vaccinate results in a vaccine-preventable disease. Evidence suggests that one of the most persuasive and effective means of communicating vaccine information to some parents is the anecdote [3].  A story shared between parents, or between parent and provider, can sometimes have a greater and lasting impact than a Vaccine Information Statement handed to a parent at a doctor’s visit.

With the rarity of vaccine-preventable diseases in developed countries, there is an associated lack of awareness about them. Health education activities brought home from school can also have a positive influence on how parents understand and manage health issues. Children can act as behavior change agents regarding health-related issues which is why another strategy we will use will be to spread the messages to children and adolescents by providing information about vaccine safety in schools, leading to pro-vaccination behaviors in parents similar to anti-smoking campaigns which focused on teaching children about second-hand smoke, which were very effective and also had a positive influence on their parents [4]. We hope to replicate this by focusing on children and adolescents with age-appropriate factual material with the hopes of introducing these children to thinking critically and how to verify authenticity of information they read.

Training will involve six 1-hour working lunch sessions comprised of the following:

1. Knowledge Assessment: this will be in the form of a ‘Jeopardy-type’ questions-answer game. Questions will determine knowledge level of participants on vaccine safety, efficacy and popular vaccine misconceptions.
2. Evidence-Based Facts: the second hour will be presenting essential vaccine and immunization facts including information on eradicated diseases such as smallpox.
3. Similar to the second hour, this will reaffirm the efficacy of vaccines and include common misconceptions found in the anti-vaccine movement
4. Narrative Development: the fourth hour will be on sharing or re-telling an anecdotal pro-vaccine story
5. Knowledge Assessment: A second ‘Jeopardy-type’ questions-answer game to assess effectiveness of training
6. Distribution of Fact-sheets and Vaccine Information Statements featuring vaccine terminology and vaccination schedules

 

At the end of the sessions:

• Public Health Professionals should be able to facilitate a discussion or support group composed of individuals reluctant to get themselves or their children immunized.
• PHPs should be familiar with at least one case study of a previous antivaxxer getting themselves or child immunized
• PHPs should be able to talk about the effectiveness of vaccines in a calm, polite manner and be able to provide facts about vaccines and be able to point to reputable resources for more knowledge

Fact-Checking the Anti-vaccine movement Phase III

References

1. Salmon DA, M.L., Omer SB, Chace LM, Klassen A, Talebian P, Halsey NA., Knowledge, attitudes, and beliefs of school nurses and personnel and associations with nonmedical immunization exemptions. Pediatrics, 2004. 113(6): p. 552-559.
2. Ashley Shelby, K.E., Story and Science: How Providers and Parents can Utilize storytelling to combat ant-vaccine misinformation. Human Vaccines and Immunotherapeutics, 2013. 9(8): p. 1795-1801.
3. Betsch C, U.C., Renkewitz F, Betsch T., The influence of narrative v. statistical information on perceiving vaccination risks. Medical Decision Making, 2011. 31(5): p. 742-753.
4. Arede M, B.-A.M., Bouchard É, Singh Gill G, Plajer V, Shehraj A, Adam Shuaib Y., Combating Vaccine Hesitancy: Teaching the Next Generation to Navigate Through the Post Truth Era. Frontiers in Public Health, 2019. 14(6).