Whose advice should you trust when deciding whether or not to vaccinate?

Trust

It's the most important word in the title, and indeed in our lives as a whole. It dictates many or all aspects of our lives. Healthcare is no exception. This is despite the pervasive perception that healthcare is purely methodical and has a minimal, if any, emotional component. In fact, research shows that physician recommendations are one of the strongest predictors of vaccine acceptance. So with that, it's important to look at the role of trust in vaccine acceptance.

With that, I`m going to direct your attention to one particular phrase in the title - “Not even the statement; just that one core word. Trust. We’re the most vulnerable we'll ever be when we are under the care of a physician.

Given this, ideally we'd completely trust our healthcare providers when making important decisions like vaccination - and for many, that is indeed the case. Trust your healthcare provider, get the vaccination. Simple, right?

Not quite

There`s an entire chain of trust behind this. You can also conceptualise it as a hierarchy. What I mean is that if a patient trusts their physician, they likely also trust the institution they work in, the health authorities in the country, as well as policymakers. If trust is broken at any one point in the “chain”, this trust in the entire healthcare system can collapse.

When that happens; it breeds uncertainty. Now, humans are a highly social species. So what will we do when we`re facing uncertainty? We`ll turn to our own social groups for guidance.

So; most people trust their physicians, and their friends, family, and communities.

The issue of vaccination can be debated, turned over, intellectualised ad nauseum. However, eventually a decision needs to be made. Eventually, they'll be at the vaccine clinic and be facing the expectant health professional with a needle in their right hand. Regardless of what hard facts are presented to us, we only have our own subjectivity to rely on. It is known from research that there is significant variety among people in what factors influence their vaccination decisions.

According to the WHO's Strategic Advisory Group of Experts on Immunization (SAGE), there are three main classes into which these factors can be grouped.

The first group is inter-individual factors; including age, race, sociodemographics. A key factor in this category is trust, or more accurately, distrust of health practitioners, authorities, institutions, and policymakers.

The second class is contextual factors. In their 2021 paper, Bara Alshurman and her co-authors define contextual factors as “those specific factors related to the intrapersonal or surrounding circumstances that influence the person’s behaviours or attitudes in a particular instance (e.g., the intention to take or refuse vaccines). These may include health history, the media environment, political dynamics, among many more.

The last group I`ll discuss is vaccine-specific factors. They include concerns about vaccine safety, effectiveness, duration of protection, cost, number of doses, transmission route, location of vaccination sites, willingness to pay and fear of vaccine side effects, and fear of contracting SARS-CoV2 from the vaccine. I'll draw your attention to one extremely important term in the final two factors I mentioned. Fear. Side effects represent the unknown for people.  Fear of the unknown is probably one of the most distressing things we can experience. It's one of humanity's worst fears, along with lacking control. Let's take vaccine side effects as an example. Although it`s certainly true that side effects are extremely rare, we have no idea who will develop them, nor can we control it. And that's essentially at the core of this issue.

So how, then, do you alleviate fear? Well, you can't ever alleviate it totally. You can coexist with it, however, by learning to manage it. The best way to do that is to learn to manage it. Many people attempt to approach this by researching vaccines; however that approach has its limitations. In a 2022 article published on theconversation.com, Vinod Goel, Professor of Cognitive Neuroscience at York University Canada, discusses the limitations of nonexperts attempting to perform research on vaccines;

“Most of us are not capable of “doing our own research” on COVID-19 vaccines. We do not have the training plus years of postdoctoral experience specializing in viruses and vaccines to seriously evaluate the primary literature, much less generate our own research. Even my family doctor, neurologist and cardiologist depend on the research produced by immunologists and vaccinologists.”

I`d say these principles apply to all vaccines; as opposed to just the SARS-CoV2 -specific vaccines. The individual may indeed have good intentions, such as understanding vaccines. Even if one has a limited amount of experience in the relevant area; they don't automatically qualify as an expert.

However, I`d argue against the assertion that there is no value whatsoever in people doing their own research. We can read (and I'd actually recommend reading) websites like the CDC, WHO, and even the FDA to gain an understanding of the facts about vaccines. Although not experts, it can give people a sense of stability in their own decisions.

These factors all have differing contributions to the final decisions for different people. It's clear, then, that vaccine hesitancy isn't a unilateral issue. It is a framework of interlinked scientific, social, psychological, and philosophical issues. This understanding really provides an avenue into discussing how complex the issue really is. So, for many people, what encourages them to make the final decision is a strong recommendation from the physicians, social support, and doing their own research. For the vast majority of people, all these factors have to align.

Conclusion

Lack of control and fear of the unknown are (in my view) two of humanity's biggest fears. These fears are really at the core of this issue. Thanks for reading.

Republished from Worldwide Health News

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