Pediatric Infectious Diseases, Dalhousie University, Canadian Center for Vaccinology, IWK Health Center, Halifax, Canada.
Adv Exp Med Biol. 2013;764:81-98. doi: 10.1007/978-1-4614-4726-9_6.
Despite significant efforts by governments, organizations and individuals to maintain public trust in vaccines, concerns persist and threaten to undermine the effectiveness of immunization programs. Vaccine advocates have traditionally focused on education based on evidence to address vaccine concerns and hesitancy. However, being informed of the facts about immunization does not always translate into support for immunization. While many are persuaded by scientific evidence, others are more influenced by cognitive shortcuts, beliefs, societal pressure and the media, with the latter group more likely to hesitate over immunization. Understanding evidence from the behaviour sciences opens new doors to better support individual decision-making about immunization. Drawing on heuristics, this overview explores how individuals find, process and utilize vaccine information and the role health care professionals and society can play in vaccine decision-making. Traditional, evidence-based approaches aimed at staunching the erosion of public confidence in vaccines are proving inadequate and expensive. Enhancing public confidence in vaccines will be complex, necessitating a much wider range of strategies than currently used. Success will require a shift in how the public, health care professionals and media are informed and educated about vaccine benefits, risks and safety; considerable introspection and change in current academic and vaccine decision-making practices; development of proactive strategies to broadly address current and potential future concerns, as well as targeted interventions such as programs to address pain with immunization. This overview outlines ten such opportunities for change to improve vaccine confidence.
尽管各国政府、组织和个人为维护公众对疫苗的信任做出了巨大努力，但仍存在一些担忧，这些担忧有可能破坏免疫规划的有效性。疫苗倡导者传统上侧重于基于证据的教育，以解决疫苗相关问题和犹豫。然而，了解有关免疫接种的事实并不总是意味着对免疫接种的支持。虽然许多人被科学证据所说服，但其他人更容易受到认知捷径、信仰、社会压力和媒体的影响，后者更有可能对免疫接种犹豫不决。从行为科学中汲取证据为更好地支持个人在免疫接种方面的决策提供了新的途径。本文利用启发式方法，探讨了个体如何寻找、处理和利用疫苗信息，以及医疗保健专业人员和社会在疫苗决策中的作用。事实证明，旨在遏制公众对疫苗信心侵蚀的传统循证方法既无效又昂贵。增强公众对疫苗的信心将是复杂的，需要比目前使用的策略更广泛的策略。成功将需要改变公众、医疗保健专业人员和媒体了解和接受疫苗益处、风险和安全性的方式；需要对当前的学术和疫苗决策实践进行深刻的反思和变革；需要制定积极主动的策略，广泛解决当前和潜在的未来问题，并采取有针对性的干预措施，如解决免疫接种疼痛的方案。本文概述了改善疫苗信心的十大变革机会。
