Various Reasons For Vaccine Refusal
A person who says no to a specific vaccine such as for COVID-19 or childhood vaccines, for example is often not anti-vax. People refuse vaccines for many different reasons, and only some identify themselves with the vaccine-refusal movement.
Many people may just be fence-sitting about the COVID vaccine, or have specific concerns about some vaccines while accepting others.
People are saying, I need more data, I want to see how the rollout goes. People might say, I will get a vaccine, but I dont want to be the first to have it I want to see what happens to the other millions of people before I commit to it.
Its also plausible to think that people who have had other vaccines would refuse a COVID vaccine because theyre scared of things like how quickly they were developed, concerns about new mRNA vaccines, or different perceptions of COVID-19 relative to other diseases against which we vaccinate.
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Then theres a group of people who refuse all vaccines, and theyre unlikely to take a COVID one, too.
According to Dr Rozbroj, the anti-vax movement has been associated with the natural movement of health, wellness, and a natural lifestyle.
When Fears Become Phobia
Getting medications or vaccines through a needle or having blood or other fluids taken by a needle can be painful. Many people remember the discomfort and pain and worry about it occurring again when they return to get health procedures involving needles. This is typical. Younger children have fewer ways to handle their fears and need help and comfort from their parents or other caregivers. As children get older, many find ways to handle their fears on their own.
But for some, these fears are more severe, can persist into adolescence and adulthood, and are best described as phobias. Needle phobias can be learned from a past experience of pain, but there is also a biological component that makes some people react very strongly to the idea of procedures involving a needle.
Phobia means extreme fear that does not fit the danger or damage involved. Phobias are sometimes called irrational because the feelings are real but much more extreme than the actual danger or harm.
Needle Fears And Phobia Find Ways To Manage
You can learn to manage needle fears
Many people do not like needles as part of medical procedures when they receive care. But for some, the fear of needles is so great that it might prevent them from getting life-saving medical care, like vaccinations. This fear often affects children but can affect adults, too. Fear of needles is also common in people with certain conditions that cause difficulties with managing strong sensations, such as in people with mental, emotional, or behavioral disorders. Fear of needles can also be common in people with disabilities that make it hard for them to understand the procedures and communicate their concerns. There are ways to manage this fear. Learn what you can do so fear does not get in the way of important medical care including vaccines.
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Sense Of Rejection And Exclusion
As social beings, we are extremely sensitive to rejection. Rejection may be more common and painful for some than for others. These people feel more excluded from society and do not recognize themselves in the official discourse or the norms being proposed in response to the pandemic.
When health measures are announced, these people may find them controlling. When one feels neither represented nor listened to by the authorities, or when one is parodied or criticized by other groups in society, the wounds of a past marked by rejection are reactivated and replayed.
These people will also feel excluded and less likely to follow recommendations. They are also more likely to feel better understood by alternative and refractory voices that make them feel heard at last.
Why Do Parents Worry About Vaccines
- By Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing
We are in the midst of a measles epidemic. As of July 25th, more than 1,100 cases have been reported in 30 states since the beginning of the year. Thats the highest number since 1992 and since measles was declared eliminated in 2000. Given that measles is extremely contagious the virus can linger in rooms even after a sick person has left and can lead to serious complications, this is really alarming.
There is a simple way to help: get more people immunized.
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How To Conquer The Fear
When attempting to combat needle phobia, make short-term and long-term goals. For folks preparing on their own for an upcoming appointment, having a personal plan for the day of the injection is important. For those who need professional intervention, Cohen recommends meeting with a specialist who can develop a plan that is unique to personal needs and goals.
Cohen suggests cognitive-behavioral interventions, which help people change the thoughts and behaviors that are causing mental health issues and emotional challenges by learning about the connections between those thoughts and behaviors.
In Cognitive Behavioral Therapy , a patient could recognize the thought thats leading to their avoidance and disrupt that distortion by attempting to change the thought. A therapist would help the patient fact-check fears even in tangible wayslike looking up statistics or other important information onlinein order to promote more helpful thoughts.
Another option is Acceptance and Commitment Therapy which encourages people to compassionately acknowledge unwanted thoughts while choosing actions that align more with their values and beliefs. Although I didnt seek professional support when developing my own action for vaccination, I practiced ACT skills Id learned in the past by clarifying my values and developing a strategy to support that belief.
Finding The Right Message And Messenger
In New Orleans, school district officials see the vaccine as key to getting schools back to something resembling normal this fall. The district launched a pilot program this summer to encourage eligible students to get a COVID-19 vaccine and to figure out what messaging around vaccines resonates with families ahead of the school year.
COVID-19 hit Black communities across the country disproportionately hard. At one point during the pandemic, the New Orleans area had the highest death rate per capita in the country.
The district there partnered with major health systems in the area to host vaccination drives for students over 12 enrolled in its summer programs, similar to what it had done for teachers this past spring. The turnout, however, has been vastly different. Families have been far less enthusiastic than teachers were to get the vaccine, and district officials quickly realized they had to do more than make the vaccine easily accessible, said Tiffany Delcour, the chief operations officer at NOLA Public Schools.
Week one showed us immediately that we have to do a lot more work with engagement, information sharing, before the start of the school year, she said.
The district plans to hold town halls with local medical experts for families and is exploring the possibility of offering incentives, such as meet and greets with New Orleans Saints players or even doing away with schoolwide mask mandates if enough students in a given building get vaccinated.
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Possible Solutions To Escalating Problems: A Call To Action
Social media has also been weaponized against the public health community to spread disinformation and misinformation, and the public health community has yet to devise a successful strategy to mitigate this destructive use of social media.
Moore et al.
Two possible solutions to address misinformation on vaccine hesitancy and climate change are:
â¢ Education and improved public messaging
â¢ Regulation of social media content.
I Would Urge Governments To Stop Thinking They Can Reach The Mass Of Niches Out There With One Mass
For the former, graphics showing the relative risks of the vaccines, compared to the actual disease, can provide some context. For the latter, Razai suggests that we need more education about the history of the vaccines’ development. The use of mRNA in vaccines has been studied for decades, for instance with long trials testing its safety. This meant the technique could be quickly adapted for the pandemic. “None of the technology that has been used would be in any way harmful because we have used these technologies in other areas in healthcare and research,” Razai says.
Sarah Jones, a doctoral researcher who co-led the IGHI report, suggests a targeted approach will be necessary. “I would urge governments to stop thinking they can reach the mass of niches out there with one mass-market vaccine message, and work more creatively with many effective communications partners,” she says. That might involve closer collaborations with the influencer role models within each community, she says, who can provide “consistent and accurate information” about the vaccines’ risks and benefits.
Making vaccine centres easy for locals to get too – like this one in India – makes them more likely to be used
* David Robson is the author of The Intelligence Trap: Why Smart People Do Dumb Things. His next book is The Expectation Effect: Transform Your Health, Fitness, Productivity, Happiness and Ageing, to be published in early 2022. He is on Twitter.
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What This Means For You
If you have a needle phobia, develop an immediate plan for your COVID-19 vaccine and a long-term plan for future vaccinations. Consider professional help if you need it and enlist the help of a supportive loved one for the day of your injections. Remind yourself why you feel vaccination is important to promote success.
Common Side Effects Of Covid
Vaccines help the body develop immunity by activating T and B lymphocytes, which detect the targeted virus and generate antibodies to attack it. Most vaccines are reactogenic in nature and may cause certain side effects which are mild in nature, and resolve on their own in a matter of few days. According to the Centers for Disease Control and Prevention , and the World Health Organisation , some of the common side effects of Covid-19 vaccines include fever, headache, chills, body aches, fatigue, and nausea. Side effects may also occur around the injection site, which is generally the upper arm. Swelling, discomfort, redness, an itchy rash, and other minor types of irritation may occur.
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Why Are Parents Hesitant To Vaccinate
I have been a pediatrician for 28 years. I talk to a lot of parents who are hesitant to vaccinate. Heres what they tell me they worry about:
Side effects. Its certainly true that vaccines can have side effects. Any medical treatment can have a side effect. With vaccines, the most common side effects are mild, like soreness where the needle went in, or a slight fever. Serious side effects are rare. There is a database, called the Vaccine Adverse Events Reporting System, which keeps track of all reported side effects. The information is publicly available, and I always encourage parents to look at it.
Autism is not a side effect of vaccines. I can understand why people might look at vaccines as a possible cause of autism. The symptoms of autism become apparent early in life, which is a time when we are giving a lot of vaccines . But this has been researched extensively, and there has been no link found. There are lots of other things going on during pregnancy and those first couple of years, and hopefully we will find the cause of autism soon. But its not vaccines.
Its normal, and understandable, to be afraid as a parent. But we need to be afraid of the right things and we need to make decisions that keep everyone safer.
Tell The Nurse About Your Fears Before Getting The Shot
There may be techniques they can use, or products available, to reduce the pain or be more patient, Dr. Rajapakse said.
If it would help to have someone with you for support, some vaccination centers may allow it, but you would have to ask ahead of time.
Some peoples fears may be so severe that theyre at risk of fainting. If thats the case, the nurse may be able to administer the shot with you lying down, or otherwise help reduce the risk, Dr. Rajapakse said.
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Focus On The Benefits
For some people, the nervous anticipation of the shot is nearly as bad as the pinch itself.
But in the case of the Covid-19 vaccine, theres a lot to look forward to if the vaccine succeeds in allowing a return to normalcy. Dr. Rajapakse said that when she got her first dose, my personal feeling was one of optimism and excitement rather than feeling nervous about it.
Keeping that at the front of your mind can make this a little less of a nervous experience for you, she said.
The media can do its part by showing fewer images of people looking uncomfortable while a needle goes into their skin, which can aggravate feelings of anxiety, Dr. Rajapakse said.
A good countermeasure is all of the positive photos emerging on social media of people holding their vaccination cards, she said. The more selfies, stickers and grateful posts people see, the more likely they are to associate the vaccine with positive feelings, she said.
Myth #: Vaccines Aren’t Worth The Risk
Despite parent concerns, children have been successfully vaccinated for decades. In fact, there has never been a single credible study linking vaccines to long term health conditions.
As for immediate danger from vaccines, in the form of allergic reactions or severe side effects, the incidence of death are so rare they can’t even truly be calculated. For example, only one death was reported to the CDC between 1990 and 1992 that was attributable to a vaccine. The overall incidence rate of severe allergic reaction to vaccines is usually placed around one case for every one or two million injections.
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Risk And Reward For Older Adults
Trust is often pointed to as a really important factor in whether or not someone gets a vaccine, Reber said.
She believes how well facilities do in getting people vaccinated is one issue, though generally nursing homes have good access to vaccines. And facility residents are also likely similar to older adults in the community who simply eschew vaccines in general. They may worry about side effects or doubt they work or figure the illness isnt that bad.
Black residents are particularly likely to be in higher-risk facilities where vaccination rates among both residents and staff are low, the Brookings Institution report says. And Black people are also more apt to mistrust a medical system some view as rife with inequality.
But with one vaccine approved for those over 16 and others in the process, long-term care facilities will have to overcome skepticism by unvaccinated staff or risk losing federal Medicare and Medicaid funds, President Joe Biden announced last week.
Its a mandate critics call unfair. Focusing only on nursing homes will cause vaccine-hesitant workers to flee to other health care providers and leave many centers without adequate staff to care for residents. It will make an already difficult workforce shortage even worse, Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living, told CNN.
Acknowledging The Role Of Information
For decades, the communication of reliable, accessible information about vaccinesbacked with sound, scientific datahas been central to the strategy of addressing fear and inspiring action. Yet that strategy does not seem to be working as well as it once did. Even with an increase in the amount of information sharedby some counts up to four times morea national survey of healthcare providers in 2009 found that 43% thought parents level of concern had greatly increased while 28% thought it had moderately increased compared with levels five years prior.
One solution could be a communications campaign targeted to doctors. According to Phyllis Arthur, Managing Director of Infectious Disease and Diagnostics Policy for the Biotechnology Innovation Organization , Patients parents often cite the recommendation of their health care provider as one of the most important factors in their decision whether to vaccinate. Doctors need to be incentivized to stand up for vaccineseven with patients that might disagree. They also need to be told how to communicate about them in a way that works.
While such changes can seem nuanced, pursuing communication without a strong methodological approach can actually do more harm than good. A 2014 study, for example, found that when parents who are hesitant about vaccines are given more information, their concerns and misperceptions about vaccines increased and they were less likely to immunize their children.
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During And After The Second World War Scientists Used Human Guinea Pigs To Test Vaccines In Ways That Would Be Inconceivable Today Tell Us About The Very Different Cultural Contextand Some Of The Most Egregious Cases
In the midst of World War II, it became an imperative to combat the spread of infectious diseases on the front lines. People in powerless positions were conscripted for tests, like an experimental flu vaccine involving young offenders breathing in flu virus through a gas mask. Or they were infected with typhus, with terrible results. When the war ended, the mentality of privileged access to these people for the greater good continued in the American medical establishment, not only among high profile researchers, like Jonas Salk, but also the institutions that backed them, like the NIH.
The man who would go on to become the head of vaccine regulations for the entire U.S., Roderick Murray, infected healthy young men in federal penitentiaries with deadly hepatitis B virus. He was trying to see if the virus was carried in the blood of people who had had jaundice, so he took blood from people who had had episodes of jaundice and injected it into prisoners. More than a score of these previously healthy young men contracted what is a very serious and often fatal disease. But that was the ethic back then. In 1964, the first place the Wistar Institutes new rubella vaccine was tested was in an orphanage operated by the Archdiocese of Philadelphia. The Archbishop of Philadelphia even gave the vaccine trial his blessing.