Doctors and nurses key to preventing vaccine refusal outbreaks

Well-informed doctors and nurses are the key to preventing parents refusing childhood immunisations because of vaccine scare campaigns, a University of Sydney expert writes in the latest edition of the international journal Nature.

Dr Julie Leask, senior research fellow and senior lecturer at the University of Sydney, has written the Comment piece in Nature’s 26 May special vaccines issue, which explores the unwarranted safety fears that threaten the promise of new vaccines.

“Health professionals are key in tipping a scare towards widespread vaccine rejection,” says Dr Leask, who notes that health professionals can be swayed by community concerns about new vaccines, even when those concerns are not scientifically founded.

“Parents repeatedly rate [health professionals] as their most trusted source of advice. So if doctors and nurses lose confidence it can have a profound effect,” says Dr Leask, who has spent 14 years researching the field of immunisation take-up and currently leads the social sciences unit at the National Centre for Immunisation Research at the Children’s Hospital at Westmead.

“More time should be spent on immunisation in medical and nursing curricula; continuing education should be provided; and timely updates issued when scares arise,” she says.

And rather than focusing on the parents resolute in their opposition to vaccination, communication strategies should focus on the hesitant parents, she argues. “We can and must work harder to head off such scares by better engaging fence-sitting parents and wavering health professionals.

“More pragmatically, systems should be put in place to prompt doctors or nurses when a vaccine is due or overdue, to evaluate their performance as vaccination providers, and to enable suitably qualified health professionals to give a vaccine without a doctor’s involvement each time.”

Dr Leask adds that while communication strategies are a key to promoting vaccination, structural barriers, such as transport to a vaccination centre or finances, should also be addressed.

“Countries with high child-immunisation rates have well-oiled systems: free and accessible vaccines, national record keeping and reminders. Financial incentives for parents and providers and sanctions such as exclusion of unvaccinated children from childcare during outbreaks or compulsory immunisation also have an effect.”

www.sydney.edu.au