Why do parents who usually vaccinate their children hesitate or refuse?

The issue of vaccination hesitancy and refusal often makes headlines in the media and worries health authorities. However, a new study by Dr. Anat Gesser-Edelsburg, Dr. Yaffa Shir-Raz and Prof. Manfred S. Green from University of Haifa, School of Public Health, published in the Journal of Risk Research suggests that even parents who are not "vaccine refusers" and who usually comply with the routine vaccination programs may hesitate or refuse to vaccinate their children based on poor communication from the relevant healthcare provider, as well as concerns about the safety of the vaccine.

The study examines parents' refusal or hesitancy to vaccinate their children following the 2013 polio outbreak in Israel. While no clinical cases of paralytic polio were recorded during the outbreak, the Israeli Health Ministry launched a campaign to immunize children under the age of 10, who were already protected with the standard inactivated polio vaccine (IPV), with a bivalent oral polio vaccine (OPV) designed to protect others who were not already vaccinated against the disease.

The study draws on results from a questionnaire survey, and content analysis of parents' discussions in blogs, Internet sites, and Facebook.

Although the rate of children vaccinated during the campaign was high, the study's findings indicate that for the first time, parents who are not "vaccine refusers" and who usually comply with the routine vaccination programs, hesitated or even refused to vaccinate their children. One third of parents surveyed, who refused or were hesitant to vaccinate their children, reported that the safety of the vaccine was a concern, and that they were not convinced by the information communicated by the Health Ministry, or the explanation of why this vaccine was necessary.

Over a third of all respondents strongly disagreed that the Health Ministry had provided comprehensive and clear information about the reasons for giving children the vaccine, and almost 28% of parents who vaccinated their children indicated that they did not actually understand that the purpose of the vaccine was not to protect their own child.

The researchers went on to suggest that, in the long term, the perceived ambiguity in communications could create mistrust in the health care system. The theme of distrust in the medical establishment recurred in the analysis of 35 respondents who had refused or were hesitant about vaccinating their child.

This case emphasizes the importance of transparency and credibility in health communication. For example, The Health Ministry claimed that the OPV vaccine had 'zero side effects'. Findings indicated that claiming there is no risk whatsoever was interpreted as neither respecting the public or credible. The researchers recommend that in future instances the risk-communicating organizations should 'expose the dilemmas, communicate facts, and 'talk science' even to laypeople, especially in conditions of uncertainty: the communicators must educate the public and include it, and not speak in all-or-nothing slogans'.