Priorities for the National Vaccine Plan (2010) / Chapter Skim
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3 Informed Vaccine Decision Making
3 Informed Vaccine Decision Making
Pages 79-96
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From page 79... ...
Such an approach requires communication that supports vaccine decision making by the public, providers, and policy makers by conveying detailed information about risks and benefit to both the individual and the community (in an appropriate context and effectively translating scientific uncertainty and other complex but important concepts) ; valuing individual autonomy and the needs of engaged patients and parents; and increasing the public understanding of vaccine policy making.
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From page 80... ...
On the one hand, the increasing prominence of vocal opposition to vaccines and immunization accompanied by data indicating diminished trust in government public health agencies and vaccine manufacturers causes great concern that these may lead to lower vaccination rates and increased threat of vaccine-preventable diseases. On the other hand, the high-profile of controversies about the safety of vaccines for children may obscure the fact that immunization is important at every age, and unfortunately adult immunization rates in the United States are low for most vaccines recommended by the Advisory Committee on Immunization Practices (ACIP)
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From page 81... ...
fueled by several well-publicized vaccine injury compensation cases. As discussed in Chapter , monitoring and assuring6 vaccine safety are the responsibility of several government agencies, most notably the Food National Childhood Vaccine Injury Act, Public Law 99-660, 4 U.S.C.
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From page 82... ...
However, communicating about vaccines, including vaccine safety, has been a complex and, for government public health agencies and their partners, a largely unsuccessful endeavor. This is in part due to the increasing polarization in the public debate, "which has limited effective dialogue between the contrasting viewpoints.
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From page 83... ...
Public health and medical communities' slowness in adapting to the gradual shift in the context of vaccination and fully utilizing existing evidence to improve the communication efforts as evident in the following: Decreasing societal consensus about the benefits of immunization • Gaps in patient and public knowledge about vaccines and • immunization Gaps in provider knowledge • 2. Gaps in the research and evidence needed to inform communication.9 9 The old approach to risk communication complemented the use of child immunization requirements, a successful policy instrument that has helped to dramatically lower rates of vaccine-preventable diseases (Malone and Hinman, 2003)
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From page 84... ...
, the high profile of vaccine controversies in the mass media, and the knowledge gaps among both providers and patients may indicate that not enough is being done to apply what is known to the development of a comprehensive communication strategy. The committee was informed by stakeholders at its April 2009 meeting on Goal 3 of the plan that some health care providers lack the knowledge, training, and materials to convey information about vaccine risks and benefits to patients.
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From page 85... ...
As part of the NVAC-NVPO process for the ISO agenda, one stakeholder and three public engagement workshops (convened in Alabama, Oregon, Indiana) have been held; stakeholder and public comments have been solicited via the Federal Register and other outreach; and an NVAC vaccine safety writing group has developed a list of research gaps and criteria for prioritizing items in the ISO research agenda that was used as a basis for discussion at a stakeholder meeting held in March 2009.
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From page 86... ...
The committee found limited evidence of efforts to evaluate communication activities undertaken by government public health agencies and their partners (Irving et al., 2007)
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From page 87... ...
A NATIONAL VACCINE COMMUNICATION STRATEGY The communication efforts of most government public health agencies appear to have been slow to adapt to the new environment and the new challenges described in this report. Public confidence in the national vaccine program and awareness of the value of immunization has deteriorated (Cooper et al., 2008; Irving et al., 2007; Sheedy, 2009)
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From page 88... ...
There also are inequities in education, access to, and utilization of information technology across different segments of the population that will also have an impact on the vaccine communication strategies that need to be developed. A communication strategy cannot be a one-size-fits-all informed decision making process.
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From page 89... ...
. To promote informed consent and informed decision making, the National Vaccine Plan needs to take account of the gaps in current communication and education and to address the complexity of public and stakeholder concerns surrounding vaccines and immunization.
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From page 90... ...
Recommendation 3-1: The National Vaccine Plan should incor porate the development of a national communication strategy on vaccines and immunization targeting both the public and health care professionals. Such a strategy should: (a)
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From page 91... ...
While health risk communication has benefited from burgeoning research, progress on the science and practice of vaccine risk communication has been minimal as has movement toward rigorously evaluating the effectiveness of risk communication strategies (Irving et al., 2007) .12 Risk communication in the context of vaccines and public and individual health risks 12 Communication on H1N1 vaccine could be considered a starting point or case study for evaluation.
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From page 92... ...
As noted in the 1994 National Vaccine Plan, research is needed on an ongoing basis to assess the public's perception of vaccines and vaccine safety, to provide information about how people make vaccination decisions, and to ascertain how these decision factors may vary among subgroups, in order to ensure that communication efforts are appropriately targeted. Ongoing research is needed to address issues related to the best way to address scientific uncertainty in safety information on vaccines, tailor messages to different groups, and take advantage of emerging technologies and communications strategies (e.g., blogs, social networking sites)
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From page 93... ...
1996. Vaccine Risk Communication: Lessons From Risk Perception, Decision Making and Enironmental Risk Communication Research.
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From page 94... ...
. Transcript, Fourth National Stakeholder Meeting of the IOM Com mittee on Reiew of Priorities in the National Vaccine Plan.
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From page 95... ...
:1981-1988. PEW Internet & American Life Project.
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From page 96... ...
PRIORITIES FOR THE NATIONAL VACCINE PLAN Wakefield, A.J., S.H. Murch, A
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