Midwives, health visitors, school nurses have an important role in promoting vaccination to parents, says a new report that raises concerns about the influence of social media on take-up.
The report from the Royal Society for Public Health found doctors and nurses were among the most trusted sources of information when it came to vaccination, with 92% of parents reporting they valued their advice.
“These healthcare professionals are likely to be trusted by and accessible to parents”
However, the report also revealed lingering myths and misunderstandings – often influenced by social media content – with fear of side effects the most common reason for choosing not to vaccinate.
A survey of more than 2,600 parents found two in five – 41% – parents had been exposed to negative messages about vaccines on social media. But that increased to around half for parents with children.
Across the board, the research found people were more likely to see negative message about vaccination on social media than they were to see positive messages, said the report, which warned misinformation could have “dangerous consequences”.
“At present, it seems that the powerful tool of social media is being utilised more prominently by those looking to spread negative information and ‘fake news’ about vaccinations,” said the report – titled Moving the Needle.
The findings were based on a series of surveys and interviews including a survey of more than 200 healthcare professionals – mainly nurses – involved in delivering vaccinations.
“History has taught us that fear and misinformation about vaccines can cause substantial damage”
As well as the rise of social media, healthcare professionals said the influence of the media in general was a key factor in whether or not people chose to get vaccinated.
“The power of the media was mentioned consistently by the healthcare professionals we interviewed, and many said they had directly experienced fluctuations in uptake according to stories in the media,” said the report.
This was especially the case when it came to the MMR vaccine, which was controversially linked to autism in a now widely discredited research paper by Andrew Wakefield published more than 20 years ago.
“The damage of the Wakefield controversy is still felt. When we talked to healthcare professionals, the MMR vaccine was frequently mentioned as presenting problems for uptake,” said the paper.
One general practice nurse who was interviewed suggested some families were very much influenced by scare stories they read online.
“There’s been a change with regards to MMR – it’s better now than it was, but there’s still some people who are adamant, you know, Mumsnet are fabulous at that kind of stuff,” she said.
“It’s reassuring that trust in nurses as a source of reliable information on vaccines remains high”
The report also highlighted other barriers getting in the way of vaccination with the timing, availability and location of appointments identified as issues by both the public and healthcare professionals. Forgetting appointments was also flagged up as a key issue by healthcare professionals.
When it came to sharing accurate information about vaccination, the report said the high level of trust in doctors and nurses was “important in ensuring high uptake of vaccinations”.
But it went on to emphasise the need “maximise the use of the wider public health workforce” including health visitors, midwives and school nurses, who “all play an important role in providing information about vaccinations, especially to parents”.
The survey of parents found nearly three quarters – 72% – said they valued the advice of health visitors on vaccinations, while 70% said they valued input from midwives. More than half – 59% – said they valued the advice of school nurses regarding vaccination.
“Midwives and health visitors work with parents during pregnancy and early childhood and have the chance to start conversations about immunisation at an early stage,” said the report.
“School nurses also have important opportunities to interact with parents,” it said. “These healthcare professionals are likely to be trusted by and accessible to parents and therefore be in a good position to provide valuable, targeted support.”
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However, the report noted research by Public Health England that suggests conversations about immunisation may be happening less often.
“Over time, significantly fewer parents have reported that health visitors are discussing immunisation with them,” it said.
Encouraging healthcare professional to promote vaccinations at every opportunity under the Making Every Contact Count initiative could help boost coverage, said the report.
“It is also important that healthcare professionals have sufficient training to be able to respond to the public’s questions regarding vaccinations,” said the document.
Public Health England has developed national minimum standards for the training of healthcare practitioners and support workers “which should be fully implemented”, it added.
The Royal Society for Public Health said there was a need for a “multi-pronged approach” to improving and maintaining uptake of vaccinations in the UK.
This should include upping efforts to limit “fake news” about vaccinations online and via social media – including by social media platforms themselves.
The body also said it wanted to see vaccinations offered in a wider range of places including pop-up centres on the high street, gyms and workplaces and it called for improved reminder services to ensure people don’t miss appointments.
Society chief executive Shirley Cramer said the value of vaccinations throughout people’s lives should not be underestimated.
“In the UK, we are fortunate to have a fantastic, world-leading vaccination programme, with excellent levels of coverage,” she said.
“However, we should never be complacent: history has taught us that fear and misinformation about vaccines can cause substantial damage to even the strongest vaccination programmes,” she added.
Helen Donovan, professional lead for public health at the Royal College of Nursing, agreed that challenging misleading information was vital, especially given a recent surge in cases of measles and last year’s flu serious flu outbreak.
“It’s reassuring that trust in nurses as a source of reliable information on vaccines remains high, and the RCN’s own myth-busting Beat the Flu campaign has reached more than 1.5 million people since it launched in October last year,” she said.
“But respected authorities need to do more to tackle misleading and dangerous narratives that put all of us at risk,” she added.