Don’t try to convert the antivaccinators, instead target the fence-sitters

Knowledge, attitudes, beliefs and practices of occupational physicians towards vaccinations of health care workers: A cross sectional pilot study in North-Eastern Italy

“…[ 14 , 15 , 30 , 31 , 55 , 56 ]. Interestingly enough, a greater share of false beliefs and misconceptions was identified in older subjects: we could tantalizingly suppose that such information gaps may be understood as a consequence of an insufficient continuous medical education and, as risk perception follows the acquisition of the knowledge [ 32 , 60 - 62 ]. Such information gaps may in turn explain why the majority of sampled OPh identified influenza as a substantially indolent disease, and similarly around a quarter of the sample underestimated the probability for HCWs to develop seasonal influenza natural infection (26.1%).…”

“…As risk perception may be understood as an intermediate step between knowledge and the developing of an attitude [ 32 , 60 - 62 ], a self-reported positive vaccination status was unsurprisingly associated with a positive attitude towards vaccination (adjOR 5.806 95% CI 1.242-27.15). In this regard, although vaccination rate was well below 50% (43/92, 46.7%), our survey is consistent with previous studies on HCWs: despite data on European HCWs clearly show a very low compliance towards SIV, physicians have been usually described as more receptive to influenza vaccination than other HCWs, ultimately exhibiting similar vaccination rates [ 9 , 18 ].…”

To close the childhood immunization gap, we need a richer understanding of parents' decision-making

“…A lot of research has addressed factors associated with the convenience axis of the WHO definition (reminders, recalls, free vaccines, financial and non-financial incentives, making getting vaccinated more convenient than getting a non-medical exemption) and a lot of effort has been invested in identifying factors that affect confidence and complacency axes eg decision-making (safety concerns, social norms, risk perception, heuristics) but there is an outstanding need for interventions that effectively and reliably improve confidence. 68 Further research is needed to illuminate the interplay between the multi-layered factors within the intrapersonal, interpersonal, institutional/service delivery, community-attitudes and public health policy domains that influence parents' decisions. 30 Additionally better understanding of the socio-cultural factors that result in clustering of vaccine refusal is needed to inform community-level actions to reach and maintain herd immunity.…”

“…66 In a subsequent study, however, Horne et al 67 reported conflicting findings using similar, but not identical, messages and using different outcomes measures, concluding that emphasizing the benefits of vaccination (gained by avoiding the risks from disease) improved vaccination attitudes. On further analysis of the Horne study data (by further segmentation of parent groupings according to vaccination attitude), Betsch et al 68 showed that the positive effects found by Horne et al were attributable to the hesitant or "fence-sitter" parents in the study and that these parents' attitudes were also affected positively by dispelling myths about vaccines. These studies highlight the challenges that accompany the lack of agreed measures of vaccination constructs such as attitudes, risk perceptions, intentions and hesitancy.…”

Understanding the perceived logic of care by vaccine-hesitant and vaccine-refusing parents: A qualitative study in Australia

“…The evidence to date has shown it is very difficult to change behaviour among parents who actively refuse vaccination [15]. Providing the ‘correct’ information on vaccines improves knowledge but does not improve intent to vaccinate, indicating that simply ‘correcting myths’ about vaccines in information campaigns or public health interventions may not be effective in changing vaccination behaviours [2, 16–18]. In addition, trying to persuade non-vaccinating parents to accept vaccines is usually ineffective and often dissatisfying to both parents and health professionals [19, 20].…”