W14 Communicating vaccines (GM) Flashcards
Structuring a Vaccination consultation
What are the steps?
Confirm patient identify (N+A check)
Introduce yourself
Purpose of consultation - vaccination
Environment/ chaperone
Importance of vaccinations
Consent
Health Assessment – currently?
Allergies
Immunization History/ Experiences
Drug History
Vaccine purpose/ benefits
Possible side effects + managing
Address any issues/ concerns
Check Understanding – INFORMED CONSENT
Confirm vaccine brand/ dose
Administer Vaccine
Document
Advise on next steps e.g. boosters
Importance of vaccination schedule
What are some Empathetic Responses?
Mirroring- Mirror the volume, tone, body langauge and context of the patient
Legitimising- Putting yourself in the other persons shoes. What is it like to be them?
Supportive
Partnership Building
Respectful- Acknowledge their position, respect their knowledge
Parents/ Carers – Respect for Autonomy
KEY: you are concerned, just as they are, about their or their child’s health and wellbeing
Overloading the immune system:
* There is no increase in hospitalisation for infections following other vaccines
* Children have fewer minor infections following vaccination
* There is no evidence to support a link with atopy or autoimmune diseases
Lot fewer elements (antigens) of disease than in 80s/90s as vaccine technology has improved
What is Vaccine Hesitancy?
- Refers to delaying or refusing vaccines despite the availability of vaccine services
- May be due to belief that a vaccine may be unnecessary, ineffective or unsafe.
There is a Vaccine Hesitancy Continuum:
Some pt refuse all vaccines and others accept all vaccines, and some are in between
The 3Cs of Vaccine Hesitancy
Complacency, Convenience, Confidence
- Complacency- perceived risks of vaccine-preventable diseases are low; vaccination is not deemed a necessary preventative action. Other life responsibilities are seen as more important at that time
- Convenience- Extent to which physical availability, affordability, willingness to pay, geographical accessibility, ability to understand (language barrier/literacy issues and appeal of immunisation services
- Confidence- trust in vaccines, in the system that delivers them and in the policymakers who decide which vaccines are needed and when.
Vaccine Hesitancy: Common Questions
- Are vaccines safe?
- The diseases have disappeared, so why still vaccinate?
- Don’t all these vaccines overload the immune system?
- I use homeopathy and do not want to have conventional vaccines
- I am worried that MMR causes autism
- Why do we need to immunise babies at such a young age?
- I am breastfeeding so won’t that protect my baby against these infections?
- What additives are included in vaccines and will they harm my baby?
Vaccine Hesitancy: The Risk
- Reduces vaccine uptake
- Compromises herd immunity
- Disease outbreaks among the unvaccinated population are likely
Overcoming Vaccine Hesitancy: Proactivity
Community pharmacists have great potential to be the first contact for patients seeking treatment for minor ailments, asking questions about their health (MECC).
Proactively raise the topic of vaccinations
Allows continual positive reinforcement, and leaves the door open for further questions.
Overcoming Vaccine Hesitancy: Tailor Advice
Good quality advice from healthcare professionals is one of the main reasons patients overcome vaccine hesitancy.
Clarify main concerns about vaccine with patient – NO judgement
Establish sources of information already consulted/ source of concern.
Discuss benefits of vaccine, risk of disease.
Allow open discussion – build trust
DO NOT force the topic – offer the opportunity to come back to discuss/ discuss with GP.
Consider a follow up appointment – to prevent desicion drift.
Overcoming Vaccine Hesitancy: Be Prepared + Informed
Be familiar with key information/ information sources
DO NOT assume patient is ill-educated on the topic
Tailor the information provided
DO NOT negate risks
Do not use lots of jargon related to how vaccines work.
Be familiar with your patient demographics – need for leaflets in different languages, video sources, cultural concerns
CASE: Hesitant Flu Vaccine
Mrs Rogers is 65 years old and has come to the surgery for a flu vaccine for the first time. Her friend told her that she had the vaccine last year but got flu afterwards. Mrs Rogers says she has always thought flu was not a very serious disease and is unsure why she needs the vaccine at all.
- Explain the disease severity and why the vaccine is offered to all 65 year olds and over
- The vaccine- explain the common SE and effectiveness and why it is needed every year
- Discuss the issue of her friend saying she had flu after her flu vaccine
-explain that it could be caused by a different strain not contained in the vaccine or by another circulating virus that can produce flu-like symptoms - the vaccine takes 2 weeks to star developing an immune response so she could have developed flu within this time frame
- She could have mistook a cold for the flu disease as they both have similar symptoms
Ethical Dilemma: Should vaccination be compulsory?
Ethical basis for and against making vaccination compulsory:
The most relevant principles are
1. Producing benefits (beneficence)
2. Avoiding preventing and removing harms (non-maleficence)
3. Producing the maximum balance benefit over Harms and other costs (utility)
4. Distributing benefits and burdens fairly and insuring public participation including the participation of affected parties (justice)
5. Respecting autonomous choices and actions including liberty of action (autonomy)
6. Protecting privacy and confidentiality
7. Keeping promises and commitments
8. Disclosing information as well as speaking honestly and truthfully
9. Building and maintaining trust.
