Antidote To The Anti-Vaccination Movement: Peer-to-Peer Mentoring

Ashwin Patel, MD PhD
July 18, 2019
One of the greatest challenges we face in the healthcare industry is understanding how to talk convincingly with parents in the anti-vaccination movement.

“Anti-vaxxers” believe in abstaining from vaccinations and regular vaccine schedules for fear of them causing autism and other side effects in their children. This anti-vaxxer movement has grown in force, despite the most popular study connecting vaccines and autism being formally retracted, and the whole claim being scientifically debunked.

Thus it’s easy to assume that an anti-vaxxer parent must just be misinformed.

We can also lash out with judgment and presume their actions are irresponsible; they are endangering their child’s health一and the health of other people’s children.

However, this isn’t always true, “One common idea would be that they’re all absolutely looney-tunes, crazy people wearing tinfoil hats and reading all these conspiracy theories on crazy blogs on the Internet. And that is absolutely not the case. What I found was that most of the people who are hesitating to vaccinate. They’re really smart people, and they’re highly, highly educated.”

My wife is a pediatrician who has spent a lot of time with anti-vaxxer parents. She brings home stories of how they often present her with a lot of ‘research.’ They have spent countless hours reading about vaccinations and side effects. They have studied case reports and read many blog posts.

They want the very best for their child, and genuinely believe that what they’re doing is the very best for their child. Yet, along with this love and desire to protect their child is often something deeper:

Fear can get the best of us—especially when it’s about something we cannot control. 

But by learning more, we can gain some control. So we do what’s easiest, we go online. But based on what we stumble upon, that can sometimes make the fears even worse!

Less than twenty years ago, the CDC had declared measles an eliminated disease in the United States. It had become like polio: a fear of our parents’ and grandparents’ generations.

And now, of course, there have been multiple measles outbreaks across the country. The spread of misinformation—mainly online and on social media—is one of the major culprits.

Obviously, we’d love for people to only go to ‘trusted’ sources, but that’s not what happens, especially given the general distrust of the medical establishment that underlies the anti-vaccination movement.

This is even more problematic given that 70% of us go online to look up health information, first. Facebook groups, Twitter streams, popular blogs, and YouTube channels are all anti-vaxxer favorites. Here they become connected with real ‘peers’—parents just like them, who have the same fears and questions.

And unfortunately, unvetted, untrained folks amongst them take up the responsibility to share, advise and promote what they know, hear, and think. They mix correlation with causality. And one-to-many online patient forums allow their faulty conclusions to reach scale with a dangerous message: “Don’t vaccinate your children. Here’s why.”

And when information comes from others like you, in your voice, in a way that you understand, you are more likely to believe it. It doesn’t matter how many times doctors and scientists have unproven these claims and have spoken transparently and clearly about the safety of, and need for, vaccines.

From the work I do every day, I see the effectiveness of peer-to-peer support as a positive force to increase health awareness and knowledge, promote healthy behaviors, and improve clinical outcomes.

Making peer-to-peer work (in the right direction).

Deep-seated fear is not likely to be addressed with a simple link to a peer-reviewed article, or ten. And definitely, those fears are not going to be addressed by just ignoring these parents’ concerns.

For real change to happen, we need to address their concerns with empathy. We need to help these parents become more inclined to engage, participate and listen. Then we can share with them evidence-based information and more resources, which at least then will have an opportunity to resonate, change vaccination behaviors and improve health outcomes.

But everything starts with building a trusted relationship. This is where a peer-to-peer support program, developed with the following principles in mind, can be very successful:

1. Don’t judge. No one should be looked down upon. Anti-vaxxers are parents first. They care about their child, immensely. Judging someone is the quickest way to turn them off and make them an adversary. We need to be on the same side of the table as them.

2. Listen. Their genuine fears about vaccines need to be heard and understood. Vaccines do have some side effects and contraindications. And there are no guarantees that there won’t be any negative effects. Their concerns cannot be dismissed or downplayed.

3. Empower. They need to feel comfortable sharing their real thoughts. They need to be empowered to foster collaboration with their provider, as well as with others involved in their child’s care, including other parents/guardians and family members.

4. Support. This is a process of discovery, with ups and downs. Old concerns may resurface after being put to rest, and new concerns may just be a quick Google search away. These parents need to be supported throughout this journey.

Then we can share evidence-based information and research to help change behavior.

The good news is that this can work,

“In the Brooklyn neighborhoods at the heart of the New York City outbreak, nurse practitioner Blima Marcus holds regular meetings with small groups of ultra-Orthodox women in their homes, spending hours answering their questions. As a member of the same Orthodox community, Marcus says it is easier for her to gain their trust. Often, she said, the women are surprised by the scientific studies she brings that disprove links between the measles vaccine and autism.”

This is a great example of ‘peer support’ that we need to support, promote, and scale.

We can scale 1-on-1 peer support, it’s been done.

One of our longtime partners is the National Kidney Foundation (NKF). Providers and health systems across the country refer to their chronic kidney disease patients here for peer support.

Getting a transplant or starting dialysis can be a very scary, daunting and life-changing process. These patients often experience fear. They want to know more.

And online forums exist with plenty of misleading information to stoke those fears.

As a response, the NKF created the PEERS program to combat incorrect, outdated, and scary information provided through unvetted sources. The NKF PEERS program provides 1-on-1 peer support through a nationally distributed network of trained, vetted, and trusted peer supporters.

These peer supporters are successfully addressing patients’ fears and questions every day. They share accurate and practical information. They help patients proactively engage in their health.

We can solve this together.

Structured peer mentoring programs can drive tremendous value. We need this as a part of our overall vaccine education strategy.

We need to develop top-notch peer support programs staffed with vetted parent peer supporters trained to listen, engage, and help these parents. Then we need to raise awareness about these programs, both offline and online, so pediatricians know where to refer, and parents with concerns know where to turn.

We need to engage 1-on-1, with empathy, at scale. This will help build trust, drive healthy behaviors, promote accurate information and assuage deep-rooted concerns.

And this works and it is possible; the models exist. They are just waiting to be applied!

If you are interested in bringing the power of peer-to-peer to empower parents to address concerns around vaccinations, let’s talk!

Published By

Ashwin Patel, MD PhD

CEO + Co-Founder of InquisitHealth


Originally published on LinkedIn


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