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Vaccine safety in the next decade: Why we need new modes of trust building? Heidi Larson, PhD Professor of Anthropology, Risk and Decision Science Director, Vaccine Confidence Project 3 December 2019 [email protected]

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Page 1: s ] v ( Ç ] v Z v Æ · 5lvn dv ihholqjv idvw lqvwlqfwlyh hprwlrqdo 5lvn dv dqdo\vlv orjlf uhdvrq vflhqwlilf 5lvn dv 3rolwlfv ^ o } À ] o x z ] l v o Ç ] î ì ì ð v î ð ~

Vaccine safety in the next decade: Why we need new modes of trust building?

Heidi Larson, PhDProfessor of Anthropology, Risk and Decision Science

Director, Vaccine Confidence Project3 December 2019

[email protected]

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The team at The Vaccine Confidence Project conducts global research on vaccine confidence, examining local and global dynamics which influence vaccine decision-making.

2

Confidence in products

Confidence in providers

Confidence in policy makers and systems

The Vaccine Confidence Project

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Survey by American Society for Microbiology and Research America

https://www.google.com/search?q=public+trust+vaccine+safety&rlz=1C1GCEB_enGB836GB836&oq=public+trus&aqs=chrome.0.69i59j0l2j69i57j0j69i61j69i60j69i61.4460j0j7&sourceid=chrome&ie=UTF-8

Confidence in SAFETY

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[email protected]

https://www.theguardian.com/society/2019/jun/19/survey-shows-crisis-of-confidence-in-vaccines-in-parts-of-europe

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MAP: http://www.lemonde.fr/sante/article/2016/09/09/plus-de-quatre-francais-sur-dix-estiment-que-les-vaccins-ne-sont-pas-surs_4994856_1651302.html

Strongly disagree

agree

“Vaccines are safe?”

State of Vaccine Confidence 2016Larson et al. EBioMedicine 12 (2016) 295–301

[email protected]

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[email protected]

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5555

6666

7777

88

99

111111

1212

152020

2124

3132

3651

107

0 20 40 60 80 100 120

Immune system too weakConflicting messages

Negative experience (personal)Too many vaccinesNever had/get VPD

Mistrust doctorsConcerns about injections

Promiscuity, STI vaccineVPD have benefits

Influenced by family/friendsMistrust governments

Vaccine cause the disease they preventMistrust health authorities

Mistrust pharmaceutical companiesNatural alternatives

Against vaccination in generalNegative media reports

Not priorityRisks > benefits

Too youngVaccines too new

Do not qualifyStrong immune system

Not offered, recommended againstNot enough evidence, testing

Vaccines not necessaryLack information, misunderstandings

Vaccines don't workVPD not severe

Low risk of contracting VPDVaccine safety

Low risk of contracting VPDs

Fear of side effectsVPDs not

severe

What drives low confidence in Europe?

7

Frequency of concerns: number of qualitative studies where concerns were mentioned + number of quantitative studies where more than 20% of participants mentioned those concerns

Karafillakis & Larson (2015). Analysis of public concerns and perceptions related to benefits and risks of vaccines. ADVANCE D1.4 Report

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GPs vaccine recommendations

[email protected]

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Diagnosis:HIGH VOLATILITY

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[email protected]

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[email protected]

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[email protected]

Total percentage of safety-related concerns: 62%

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[email protected]

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[email protected]

CONFIDENCE IN SAFETY PROCESSES

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[email protected]

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[email protected]

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9-Jan-20 [email protected]

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Media analysis around rumors which prompted Ebola vaccine trial suspension in Ghana (2015)

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[email protected]

WHEN ITS NOT MISINFORMATION,BUT SEEDING DOUBT

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ROMANIA 2017http://www.feedler.ro/feed/7208497--cluj-reactie-raed-arafat-despre-panourile-antivaccin-uitati-va-la-ce-s-a-intamplat-cu-copiii-afectati-de-rujeola-lipsa-vaccinarii-a-fost

[email protected]

“Vaccines are NOT safe!...Know the risks!”

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ITALY 2018

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New Zealand [email protected]

Instilling doubts, amplifying risks

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Aluminum, mercury and other “toxic”ingredients

[email protected]

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[email protected]

WHEN ITS NOT THE VACCINE,BUT THE VACCINATION EXPERIENCE

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[email protected]

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DENMARK

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IRELAND

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COLOMBIA

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“We may be witnessing a milestone in the history of MPI (mass psychogenic illness)

where the primary agent of spread will be the Internet and social media networks

Bartholomew RE et al. Mass psychogenic illness and the social network: is it changing the pattern of outbreaks? J R Soc Med. 2012 Dec; 105(12): 509–512.

[email protected]

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[email protected]

When its not about the vaccine,but the vaccinationexperience

When its not about the vaccine,but the vaccinationexperience

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[email protected]

WHEN THE SIGNALS ARE FABRICATED(Yet still provoke panic)

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1894

“Fake news” has also been here before

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[email protected]

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[email protected]

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[email protected] Neil Johnson/GWU

This is a dynamic, fast moving landscape

“communications on steroids”

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Risk as feelings (fast , instinctive, emotional.. )

Risk as analysis (logic, reason, scientific...)

Risk as Politics

Slovic et al. Risk Analysis 2004; 24 (2): [email protected]

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[email protected]

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Looking Forward

Evidence is there, but still questioned

New questions, need more evidence

Good communication needs good science (although its not enough)

Marketing strategies can be helpful BUT need caution – those in the advertising business may not appreciate the risks of over-promotion

[email protected]

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Looking Forward (2)

Context, context, context: Local and global (“risk/benefit depends on where you live”)This is about politics, geo-politics, development and a hyper-connected, anxious populations

(“bartering vaccination for electricity”)

[email protected]

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[email protected]

Be careful with what we promise….

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[email protected]

www.vaccineconfidence.org


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