| 19.10,19. 10:10 AM |
Not all parents vaccinate their kids. But that doesn't mean they're anti-vaxxers
Photo: The factors leading parents to not vaccinate their children are complex, says Professor Julie Leask. (Getty: Halfpoint Images)
While most Australian parents vaccinate their children, there's still a minority who don't — but they're not all vehement anti-vaccination activists.
In fact, most non-vaccinating parents are simply "trying to get on with the job of parenting", says Julie Leask, a social scientist at the University of Sydney's Nursing School who researches people's attitudes to vaccines.
"Vaccine refusal is a problem for public health so it's important to have high vaccination rates. But the national conversation has become fraught," she says.
"Our research is trying to figure out how best to work with those parents to create a more productive way forward."
Professor Leask says understanding that non-vaccinating parents are not one homogenous group of people is a step in the right direction.
"There's often a lack of differentiation between anti-vaccination activists and parents who don't vaccinate," she tells RN's Life Matters.
Where there is a hesitancy towards vaccination, antagonism and shaming is futile. In fact, it's likely to more deeply entrench beliefs.
Professor Leask says a better way is to try to understand what's motivating them — the values, beliefs and experiences they bring to their decision.
So let's learn more about them.
What's driving most non-vaccinating parents
"There's usually a gap between the ideal immunisation rates and the rates a country actually has, and in that gap are two broad groups," says Professor Leask, who is also a visiting senior professorial fellow at the National Centre for Immunisation Research and Surveillance.
There is the group where parents "actively refuse some or all of the vaccinations for their child" — they don't vaccinate at all, or select out certain ones.
"They perceive vaccines to be riskier than they actually are," Professor Leask says.
The other, larger group is of parents who don't vaccinate their children because they face practical and logistical issues.
They are motivated to vaccinate, but they're busy caring for a big family, or they're single parents. They're house-bound. They can't get the time off work. There's no public transport.
If a child is in out-of-home care it can be harder to keep up with their vaccinations, or maybe a child was born overseas and the parents are yet to catch up on the Australian schedule.
Within this group facing practical barriers, there are also a significant number of parents not vaccinating their children because they believe, or they've been incorrectly instructed by a health professional, that they shouldn't get their child vaccinated as they have a minor illness.
She says this is "a major contributor" to non-vaccination.
Professor Leask says "anti-vaccination activists" make up the vast minority of people who don't vaccinate their children.
"Because that small group is loud, it creates the impression that people who don't vaccinate are synonymous with anti-vaccination activists, and that creates problems in the broader discussion," she says.
Before you challenge someone else's position, understand your own
Tomas Rozbroj, a Monash University researcher specialising in understanding vaccine hesitancy, says it's worth taking a moment to check our judgments when it comes to those who don't vaccinate.
He says his research has shown that, to pro-vaccine people, "vaccine-refusing people almost represent an anti-reason group or an anti-science group".
"In many ways [pro-vaccine people] are worried about vaccine-refusing people not just as a vector for disease, but as a vector for these broader dangerous ideas, this kind of rejection of modern logic, of modern medicine," he says.
"We project onto them broader concerns that, quite likely, have nothing to do with them or their world view."
It's a misunderstanding that can inhibit progress.
"The really important thing here is that the average person on the street can't understand why somebody would ever refuse vaccines," Mr Rozbroj says.
"And that understanding leads them to almost rely on deficits to explain it away."
A common perception, he says, is that "there must be something wrong with you to refuse vaccines".
He argues that without understanding someone's motivations, it's "much, much harder to be sympathetic".
And from that position, it's very hard to convince someone to change their mind.
Professor Leask says trying to argue someone out of a view they hold strongly, rather than trying to understand what their ideas are grounded in, can have the reverse effect.
"What can happen is that, because they're already a bit entrenched in that view, you start to enter into a debate with them rather than a discussion," she says.
"Their rehearsal of their beliefs with you can actually further entrench their existing beliefs … and you can end up with this backfire effect where those parents become more isolated in their views."
She says we need to allow more space for respectful conversations, in which people can feel safe to express doubts or ask for more information, whether from their social or online communities, or from their health professionals.
As it stands, the vaccination-hesitant parents Professor Leask researched described being "outcast by their peers if their vaccination decision comes up".
When they share their questioning of vaccination they "get this big pile-on online, even though they weren't really against vaccination, they were just sharing some questions," she says.
"So this shunning, this sometimes being abused, having these very negative experiences in the healthcare interface, having arguments with doctors and so forth — [it does] amount to what's been described in the literature as stigmatisation."
Professor Leask says her goal is to "better understand how we can treat people respectfully" in order to have productive, rather than inflammatory, conversations with parents.
"Being aware of the stigmatisation they face is really important as a first start," she says.