w3: Vaccination and vaccine hesitancy

Question 1

What is another term for vaccination?

Answer 1

Immunisation.

Question 2

What is a vaccination in the public health perspective?

Answer 2

A method of health prevention aims to build immunity to a disease. The principle of herd immunity protects those that are most vulnerable.

Question 3

When was the first vaccine?

Answer 3

1796
Dr Edward Jenner,
Using cow pox pus to vaccination against small pox.

Question 4

How efffective are vaccinations in daving lives globally by health prevention?

Answer 4

Globally vaccines sav 4 to 5 million lives a year.

Question 5

What are some noticeable achievements in measels?

Answer 5

In 1967 there were 460,000 measels cases annually.
Vaccine was introduced in 1968
2014 only 130 confirmed cases of measels.
2016 UK became a measels free area.
However, due to vacccine hesistancy in 2019 UK lost this status after 231 confirmed cases in one quarter.

Question 6

UK vaccination programme overview

Answer 6

1853 UK gov compulsory for children to have the smallpox vaccination.
Modern programme is a list of vaccines made freely available through the NHS to different age groups or vulnerable groups.

Question 7

Give some examples of vaccines that should be given to children as part of the UK vaccination programme.

Answer 7

MMR - two doses
HPV - girls only
Roatvirus
PCV
Meningitis B

Question 8

Give some examples of vaccines offered through the UK vaccination programme to over 65s.

Answer 8

PPV
shingles
Influenza

Question 9

What are some examples of selective or at risk vaccination programmes in the UK?

Answer 9

Hep B vaccines to a baby born to a mother testing positive to Hep B
TB to infants in a high risk area
Influenza and Pertussis vaccine to pregnant women.

Question 10

What is the public health benfit of herd immunity?

Answer 10

Protects vulnerable parts of society, often people who are immunocompromised such as HIV, eldery, very young, in hospital or recieiving chemotherapy treatment.
Suggest in a society where the social norm supports vaccines and positive health action.

Question 11

What is the recommended vaccination coverage for herd immunity?

Answer 11

95% of a population.

Question 12

Give some statistics on global vaccination coverage and uptake.

Answer 12

In 2021 25 million children under the age of one did not receive basic vaccines.
In 2021 the number of children who had not received any vaccines increased by 5 million.
Global immunisation coverage dropped from 86% in 2019 to 81% in 2021.

Question 13

What are some trend in the UK vaccination programme?

Answer 13

England is a world leader in childhood vaccination.
However, child uptake has been slowly decreasing since 2012.
Often a rapid increase when a vaccine is first developed then the intake drops slowly over time.
Fewer people return for second doses.

Question 14

What are the statistics for MMR uptake in the UK amongst children?

Answer 14

In 2019 94.5% of children received their first dose but only 86.4% of children received their second dose.

Question 15

How does vaccination uptake in the UK vary by region?

Answer 15

The north east and the South west have the highest regional uptake at around 91%.
London has the lowest uptake at around 77%.
England average was 86.4% in 2019.

Question 16

What is the 5C model of vaccine hesitancy?

Answer 16

Reasons why people may be vaccine hesistant
1) Confidence - in vaccines or healthcare
2) Complacency - perceived risk from illness
3)Convenience - time, travel
4) Communication/calculation - reliable source of info
5)Collective responsibility - social morals to contribute to herd immunity.

Question 17

What is the Wakefield Study?

Answer 17

Published in 1998, claimed there was a link between MMR vaccine and autism in the lancet journal.
Lead to a large decrease in vaccine uptake in UK and USA.
Study was highly flawed as only studied 12 children and Wakefield was payed by lawyers to give a biased result.
Wakefiled was struck off but the article was not removed until 2010.

Question 18

What is the difference between misinformation and disinformation?

Answer 18

Misinformation - accidentally sharing and using wrong information
Disinformation - purposefully and knowingly spreading wrong information.

Question 19

Define vaccines hesitancy.

Answer 19

The delay in acceptance or refusal of vaccines despite availability of vaccines services.
On a spectrum from refusal of all to acceptance with doubts

Question 20

Where does the WHO stand with vaccine hesitancy?

Answer 20

In 2019 WHO declared vaccines hesitancy as one of the top ten threats to global health.

Question 21

What are some interesting points or trends in the countries that have high amounts of vaccine hesitancy?

Answer 21

United states - 33% hesitant
Russia - 48% hesitant (highest)
Concerning as superpowers so large cultural influence.
Nigeria and South Africa also have around 40% hesitancy - linked to education.

Question 22

What individual factors are associated with vaccines hesitancy?

Answer 22

Past experiences
Beliefs and Attitudes
Cultural and religious beliefs
Knowledge and awareness
Risk benefit Perception
Accessibility -language barrier

Question 23

What wider based factors are associated with vaccines hesitancy?

Answer 23

Health inequalities
Structural factors - socioeconomic and education
Accessibility - public transport
Misinformation/disinformation
Lack of effective public health campaigns
Role of health care professionals.

Question 24

What methods can be used to tackle vaccines hesitancy?

Answer 24

Often a combination of:
- tailored communication from trusted sources
- cultural relevant and accessible in multiple languages.
- improve access, including reminders and alerts
- community engagement
- training and education of those in the community.

Question 25

What is important to remember about the effectiveness of communication to reduce vaccine hesitancy in a targeted community?

Answer 25

Best to workside a community leader, people respond more positivly to info and change coming from a more trusted internal source rather than external information.

Question 26

What are some statistics around COVID vaccine hesitancy in the UK?

Answer 26

72% of black ethnic groups are vaccinated
42% of South Asian and Pakistan groups were vaccinated.
Only 75% of the eligible UK population are fully vaccinated.
Lower vaccination rates in more deprived areas 87% compared to 92% in least deprived areas.

Question 27

How does COVID vaccination vary by dose?

Answer 27

93.6% had first dose in 2019
88.2% had their second dose
70.2% had a booster of third dose of the vaccine.

Question 28

What is meant by ‘Shots at the Shop’?

Answer 28

Part of 2019 Biden campaign to increase vaccine uptake in black and minority ethnic group communities in USA.
Recognises barbers central role in community, trains to contradict misinformation and encourage vaccine uptake against COVID-19, barber shops will potentially be used as sites for vaccinations.

Question 29

What are the five steps to tackling COVID vaccines hesitancy?

Answer 29

Confidence and trust
Complacency
Convenience
Communication
Context

Question 30

What fits into the context method of tackling covid 19 vaccine hesitancy?

Answer 30

Target campaigns to communities
Using community leaders and models of similar ethnic background and cultural beliefs.
Aim to understand their cultural and religious views.

Question 31

What is part of the complacency method of tackling COVID-19 vaccines hesitancy?

Answer 31

Be empathetic in communication
Do not use labels such as anti-vaxxer or conspiracy theory.
Listen to and try to understand their concerns.

Question 32

What can a clinician do to handle vaccine hesitancy in a patient?

Answer 32

Listen to concerns in a non alienating way being aware of cultural and emotional differences
Ask questions
Provide clear and up-to-date information, ensure patient has access to reliable information.
Support equity by targeting the most at need groups.
Avoid using jargon and stigmatising language.

Question 33

What is the difference between vaccine hesitancy and vaccine relucatance?

Answer 33

Hesitancy - slow decision, more information needed, not sure
Reluctance - don’t really want it but are persuaded unwillingly or pressured.