06/13/2016 11:18 EDT | Updated 06/14/2017 05:12 EDT

We Finally Know Why Some Canadians Still Refuse To Vaccinate

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Doctor giving an injecting to a girl

Vaccination is one of the most successful means to prevent infections. Yet since it was first used over 200 years ago, the practice continuously has been the subject of controversy.

In Canada, most people know and understand the benefits as well as the risks. However, an increasing number of individuals give credence to the arguments presented by groups and individuals who find vaccines may do more harm than good.

One of the major concerns about the negative perception is a rising trend in vaccine hesitancy. It's defined as a "delay in acceptance or refusal of vaccination despite availability of vaccination services." Essentially, people may go to great lengths to avoid the use of vaccines as a result of a number of reasons. Some governments such as Ontario's have taken legislative routes such as mandatory vaccinations for children. Despite this, many individuals still have doubts about a variety of vaccine choices.

Vaccine hesitancy is not limited to Canada. The doubt is growing globally and prompted researchers to find ways to slow or reverse the trend. Some are information based, while others are disciplinary, including dropping patients who will not accept vaccines. Not surprisingly, some of these strategies have not been effective and over the last few years, the numbers of hesitant individuals continues to rise.

For some, the idea of vaccine hesitancy may be nothing more than an intrinsic belief in a flawed theory postulated nearly 20 years ago, namely, the MMR vaccine causes autism. Yet, there may be far more at play than a single belief in a now-disproven accusation. Other factors could potentially increase the complexity of vaccine hesitancy. Without properly understanding these issues, there is little chance to see any change in the trends. Despite this, figuring out what truly concerns Canadians has not been given any significant attention.

Now that gap may be finally filled thanks to a large Canadian collaboration. Last week they published an examination of vaccine hesitancy in Canada. Based on their results, the reasons behind the concern over vaccine may be far more troublesome than anyone believed.

There was an overt mistrust of the vaccine, the pharmaceutical industry and even the medical establishment as a whole.

The group reached out to hundreds of Canadians working in some capacity in the immunization field. After going through the names, they found a total of 150 people who were selected to answer a variety of questions. Some dealt with the individual's views and experiences with vaccine hesitancy, while others were more focused on definitions. The aim was to determine the degree of doubt in Canada and whether it was a problem.

Not surprisingly, the results showed Canada is indeed dealing with hesitancy and it is causing a major shift in the way health care is delivered. For those on the front lines, three-quarters said it is a significant problem. Also to no one's surprise, the major vaccines of concern happened to be focused on a few vaccines including measles, influenza and human papilloma virus.

Once the actual extent was figured out, the next step was to determine the major causes of hesitancy. A lack of proper information was one of the more common reasons. Regardless of the type of person vaccine providers faced, there were inevitably one or more questions focused on links between vaccines and the onset of illness and injury.

Other troubles were seen as a result of personal beliefs. Some, such as religious practice, could be understood, but many were also deemed to be politically motivated in the form of conspiracy theories. Other less common reasons included complacency, fear of needles and a lack of convenience.

But the most common reason behind vaccine hesitancy would be considered a major blow to any health care professional. There was an overt mistrust of the vaccine, the pharmaceutical industry and even the medical establishment as a whole. People had lost faith in the process and would be skeptical of anything told to them. For the authors of this study, this proved to be quite worrisome as the answer lies in the development of trust rather than the dissemination of knowledge. In essence, vaccines would be secondary to the relationship between an individual and his or her health care worker.

For the authors, this study underscores the complexity of vaccine hesitancy in Canada. It also points to a rather poor outcome as the major issues deal with trust rather than information. Unfortunately, the trends in public perception of science, government and industry seem to be a large hindrance. Any possible efforts to use large-scale strategies would risk being regarded as yet another attempt by a large conglomerate to fool or force the individual into an unsafe position.

The study also reveals the best way to deal with vaccine hesitancy as well as with any concern over health care is to have a strong and trusting relationship between the patient and the provider. Granted, this may mean more time to discuss concerns and doubts. But in light of the benefit of vaccines on a global scale, these intimate discussions to inform and an encourage what is a truly personal decision may end up being just what the doctor ordered.

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