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Reporting On Vaccination Without Increasing Hesitancy

By Nicola Ryan – AMWA member. 31 March 2021


Achieving vaccination rates that provide herd immunity and protect populations from disease has challenged public health officials for decades. Vaccination against COVID-19 is no exception.

In the fourth presentation in AMWA’s webinar series ‘COVID-19 Vaccine – Your Questions Answered’, Professor Julie Leask, from the Susan Wakil School of Nursing and Midwifery at the University of Sydney, spoke to members about ‘Reporting on Vaccination Without Increasing Hesitancy’.

Her talk focussed on how journalists and medical writers manage reporting about vaccination, making it especially relevant to AMWA members. Another aim was to facilitate understanding how people become hesitant about vaccination. Part of the challenge of reporting on vaccination, particularly the rollout of a new vaccine such as that for COVID-19, is that this has the potential to impact on the public’s confidence in that vaccination. Writers need to report in a critical, independent way without increasing hesitancy.

Role of the media

There are a huge number of challenges in reporting on health issues, even when there isn’t a global pandemic. The current demand for information is high, but there is a need to communicate complexity and uncertainty. Health and medical writers have an important role in asking challenging and independent questions to help inform the public.

Prof. Leask also highlighted several pitfalls to avoid when reporting about vaccination, including stigmatising and stereotyping, and misinformation. These increase the challenge of encouraging widespread acceptance of vaccination.

Understanding what drives hesitancy

Individuals make decisions about whether to vaccinate based on how they think and feel in the context of their social situation, such as what others around them are saying and doing. Not everyone who chooses not to vaccinate is a “hippie” – although this is the stereotype that is often portrayed. Care also needs to be taken not to stigmatise non-vaccinating families, which has happened in the past.

Practical and logistical barriers are also highly relevant, and Prof. Leask suggested that these can sometimes account for more than half of all vaccine hesitancy. This includes the accessibility of care, convenience of services and the social determinants of health. “It’s not just what goes on in people’s heads,” she said. It is important to remember this when reporting on vaccination and vaccine hesitancy.

Understandably, potential safety issues with vaccines, whether real, uncertain or perceived, can have a huge impact on attitudes towards vaccination. The obvious example of this is the Andrew Wakefield MMR vaccine issue in the late 1990s, which resulted in a massive reduction in uptake of the MMR vaccine and a corresponding rise in measles infection rates, with very serious public health consequences.

What does this mean for uptake of the COVID-19 vaccine?

Being opposed to a vaccine does not necessary mean that someone won’t get vaccinated. This means that vaccine hesitancy is a really important issue that we need to deal with. Although people can tolerate uncertainty, this tolerance decreases (and hesitancy increases) when there is public debate between experts, such as that occurring in relation to the very rare occurrence of a specific type of blood clot after administration of the Oxford-Astra Zeneca vaccine. In addition to how expert debate is reported, the media need to be very careful about how narratives around potential adverse events are reported to avoid scaremongering. The choice of narrative can have a big influence on vaccination behaviour.

Positions on COVID-19 vaccination range from activist (at one extreme) through rejection, hesitancy and accepting, to demanding and advocating. Demanding is something we are seeing at the moment with phased vaccine delivery and rollout in this part of the world. However, each different attitude will require a different type of communication. This means that it is no small task to reach people along the spectrum of COVID-19 vaccination attitudes.

How to report effectively

Prof. Leask provided some excellent advice for those of us writing about COVID-19 vaccination issues. She recommended always going to the primary source for information (such as the phase III clinical trial publication or documentation from regulatory agencies). In addition, it is really important to acknowledge uncertainty in what is a rapidly evolving area and the dilemma that this might create. She suggested that we need to remind everyone that COVID-19 vaccines are an evolving science.

COVID-19 vaccination is also a complex topic, therefore it is important to go to the right expert for the right topic when reporting in this area, and acknowledge the range and diversity of expertise available. Although Prof. Leask cautioned about the importance of being aware of ‘agendas’ when evaluating data, including commercial, research funding, emotional, etc. Writers also need to know how to detect anti-vaccination campaigners and manage them accordingly.

Always consider the audience impact of your writing – how a problem is framed will influence the solution – and issues need to be framed in an evidence-based way. Avoid polarising your audience. Similarly, headlines are really important, because this might be all that some people read. Therefore, avoid sensationalism! Be careful with images too. Lots of pictures of needles can increase reader/viewer anxiety, and make sure you’re not showing a picture where incorrect injection technique is being used. It is also important to ensure diversity of images used to increase the applicability of messages to different sections of the population, such as indigenous groups.

Reporting on dissent and endless critique for its own sake is not helpful. From my perspective, this is an approach overused by much of the mainstream media in New Zealand. The notable exception is the collaboration between microbiologist Siouxsie Wiles and cartoonist Toby Morris for The Spinoff, whose excellence in science communication has been translated by governments and organisations around the world, and led to a collaboration with the World Health Organization (their work can be accessed here: https://thespinoff.co.nz/media/04-09-2020/the-great-toby-morris-siouxsie-wiles-covid-19-omnibus/).

Responding to misinformation

If an issue seems to be taking traction, fill the gap early with factual communication. Use trusted people and organisations to support the narrative. Don’t forget to focus on the issue rather than the opponent (e.g. don’t give too much time to a celebrity with an anti-vaccination agenda).

Reporting on safety events

Clear and regular communication is important when people are worried. Keep messages short, and emphasise evidence-based information and scientific consensus that is consistent with regulatory messages. In response to a question from the audience, Prof. Leask said that reporting on safety issues should occur when these are being discussed by regulatory authorities. She recommended listening to what vaccine safety scientists are saying (or contact them for information), and cautioned against reporting the opinions of “non-experts”.

Resources

At the end of her talk, Prof. Leask highlighted the availability of “The COVID-19 Vaccine Communication Handbook”, that she has been involved in putting together. This resource is available to AMWA members in the Members Area.  Another useful resource is the COVID-19 vaccine safety communication booklet produced by the World Health Organization.

And remember…

We vaccinate because we don’t want people to lose loved ones, to avoid lockdowns that create inequity, to allow families to be reunited, so that businesses can open safely, and for lives to be proceed as normally as possible. It’s also important to remember that while vaccination is a key part of overcoming COVID-19, it remains just as important for other diseases too.

A recording of Prof Julie Leasks’ presentation is available to AMWA members here.

Register for the next webinar in the AMWA webinar series – 'Testing for COVID-19 and Effectiveness of Vaccinations', presented by Dean Whiting, CEO of Pathology Technology Australia.


Based in Auckland, New Zealand, Nicola Ryan is an AMWA member who has worked in medical communications for over 30 years, and in a freelance capacity for the last 9 years. Nicola works directly with researchers, key opinion leaders, and pharma and medical device companies from Australasia, Japan and Europe. This has included preparation of original research articles that have been published in the New England Journal of Medicine, Journal of the American Medical Association, and the Lancet family of journals.


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