The H1N1 crisis has dramatically changed discussions around vaccines. A range of experts from different fields come together at the Merieux Foundation earlier this week. The conversation ranged from what questions were influencing public perception of vaccines to how to better understand the issues that the health community is facing today. It was fascinating to hear studies showing the impact certain rumours had on individual uptake of different kind of vaccines.
The most moving presentation came from a parent who had lost his child to the whooping cough (pertussis), reminding us why vaccines matter so profoundly to the health of our society and our children. The challenge we face however is an increasing level of scepticism from the public and intensification of rumours and scare stories spread through the web. Brian Deer, a journalist writing for the Sunday Times and the BMJ, shared his experience in investigating the case of Andrew Wakefield. Brian spoke about how he had done a long and deep investigation into the science and methodology that had gone into Andrew Wakefield’s claims and was able to dismantle his case by carefully reading a large collection of documents. He showed us that rigorous work and challenge can help to expose fraudulent claims.
The Wellcome Trust on the other hand reminded the participants that science and vaccines are still highly trusted by the public – and that a range of initiatives had helped reinforce this understanding – but a great deal of work still needs to be done. I had the opportunity to share my experience in exploring this space online, as well as the dramatic change that the internet has brought to the way we experience information. My own conclusion from this intense discussion was that there is a need for rethink of how the health community (public and private) communicates around vaccination. The internet needs to become a core tool of communication activities and the various players need to acknowledge that the public has legitimate concerns and fears and wants to get a better understanding of what is behind the recommendations and research of the experts. A much more transparent and open discussion is needed where rather than dismissing those with concerns a real conversation begins that addresses the questions and helps to understand what choices we all need to make. In many ways this conference was a step in that direction.
There was some interesting engagement on twitter during the conference (#vaxpolicy). I was particularly pleased when zdoggmd (check out his clip below) retweeted something about the conference – a great way to get the message out!
Check out my storyfication of #vaxpolicy
Cross-posted to https://blog.zn.be/2011/hyperthinkers/shifting-the-vaccine-policy-discussion/
Phil,
This is interesting because be had similar conversion in animal health at CIRAD conference, but about farmers’ decision in H5N1 HPAI endemic area in Vietnam to i) vaccine their flock against H5N1, and ii) report an outbreak to veterinary services when they occurs. This was studied there by sociologists through interviews (paper available upon request).
Here the implications are multiple.
Vaccination is essentially a commercial decision aiming to protect the flock, and here too, there is little awareness of the contribution to landscape-level flock immunity. But decision to report an outbreak is even further implications, as not declaring allows the disease to circulate regionally, expose more people to the pathogen, and enhances the risk of human exposure, and with it of a nasty form to emerge.
Farmers living in H5N1 endemic zones are permanently exposed to H5N1. But to date, all they have seen of it in their neighborhood, is a bit of over-mortality in their bird, which is something they can economically afford. So, they feel they can live with it, and do not report an outbreak, because that will imply culling with low or limited compensations. They feel a disconnect between the perceived risk in their daily actions, and the risk advertised by media and veterinary officials. In contrast, in areas where H5N1 is not circulating, farmers hear about the disease through media, and are much more inclined to report because of a lower disconnect between the perceived risk, and the “official” risk.
For the first type of farmers, the most efficient way of reducing this disconnect was through informal contacts in their “epidemiological territory”, i.e. through informal discussion with other farmers, local paravets that sells and administer vaccines, or through discussions at the market. I guess this is the equivalent of social networking….
Cheers,
Marius