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Health officials should consider a different approach to address vaccine hesitancy, say experts

The oft-repeated idea that the best vaccine is the first one offered to you may not be the right message for reaching people who are vaccine hesitant, according to researcher Maya Goldenberg.

Researcher says that advice should be specific to people's concerns

People receive their COVID-19 vaccinations from Karen Balzer at a COVID-19 in Winnipeg on Friday. Vaccine hesitancy researcher Maya Goldenberg says that providing information specific to people's concerns is key to reducing vaccine hesitancy. (John Woods/The Canadian Press)

The oft-repeated idea that the best vaccine is the first one offered to you may not be the right message for reaching people who are vaccine hesitant, according to researcher Maya Goldenberg.

"It doesn't matter if it's safe for everybody. We kind of want to know if it's safe for me or if it's a risk that I can manage," said Goldenberg, an associate professor of philosophy at the University of Guelph who studies vaccine hesitancy.

"If there's even the perception that you're just sort of doing a broad-brush characterization, saying they're all the same when they're clearly not, that's not going to sit well."

So when the federal government's National Advisory Committee on Immunization (NACI) said mRNA vaccines — like those from Pfizer-BioNTech and Moderna — are "preferred," it led to further questions about whether certain vaccines are safer than others.

NACI, an independent body of experts that makes recommendations on the use of newly approved vaccines, said on Monday that Canadians who are less at risk of contracting COVID-19 may want to wait until mRNA vaccines are available to them, given they do not carry the very rare but serious risk of blood clots. 

The committee says that viral vector COVID-19 vaccines, like AstraZeneca's, are effective. 

The following day, Prime Minister Justin Trudeau sought to reassure Canadians that all vaccines approved for use in this country are safe and effective, and urging people to get a shot when it's their turn.

WATCH | NACI under fire for changing messaging and naming 'preferred' vaccines

NACI under fire for changing messaging and naming ‘preferred’ vaccines

1 month ago
2:21
For weeks, Canadians have been told to take the first COVID-19 vaccine that they’re offered. But the National Advisory Committee on Immunization has come under fire for recently changing its messaging — calling Pfizer-BioNTech and Moderna vaccines “preferred” and that Canadians should weigh the risks of waiting for one of them. Farrah Merali digs into the mixed messages and the potential danger they can create. 2:21

Worries of government 'intrusion'

Goldenberg says a lack of science literacy isn't necessarily the reason people may be hesitant about vaccines, noting that political objections can also play a significant role.

"[Vaccines] really represent a very close intrusion of government and government policy onto the family unit and into individual bodies," said Goldenberg.

"So any kind of discontent people have around government and institutional structures and in general will get projected onto vaccines, and we see that today."

People with concerns about vaccines may also pushback against health-care systems and institutions, like the pharmaceutical industry's influence on health research.

The vaccination promotion campaign "This Is Our Shot" has employed celebrities in an effort to reach Canadians who may not be connecting with expert advice. (Tijana Martin/The Canadian Press)

The pandemic has also amplified concerns from marginalized communities who may feel that they are being used as a "test case" for certain vaccines.

"Hesitancy around COVID vaccines amongst racialized communities is getting attention in a way that pediatric vaccines were just a few years ago — [then] said to be only a problem of affluent white people, especially affluent white mothers," Goldenberg said. 

For some of the essential workers Dr. Anju Anand provides vaccinations to, the AstraZeneca COVID-19 vaccine already felt like a "second-rate" shot because of worries over its side effects.

She criticized NACI's framing of mRNA vaccines as "preferred," particularly when doses of AstraZeneca's vaccine were given to many workers in hotspot locations. 

"As soon as you use [the] word preferred, it implies that there's something else that's better," said Anand, a respirologist and member of the South Asian COVID Task Force which is working to reduce vaccine hesitancy among South Asian communities. 

"It's important to be transparent, but I think you have to also be clear in the choices of words that you use when you're communicating."

NACI member Dr. Caroline Quach said Friday the committee's recommendation was not "retrospective" and that those who received the AstraZeneca COVID-19 vaccine did not get a "second-best shot," according to The Canadian Press.

WATCH | Dr. Caroline Quach-Thanh on guidance for Johnson & Johnson vaccine

Should Canadians take first available vaccine or wait for mRNA one?

Power and Politics

2 months ago
6:33
NACI Chair Dr. Caroline Quach-Thanh joins Power & Politics to discuss guidance for the Johnson & Johnson vaccine. 6:33

Addressing particular concerns may help

A more accessible approach to vaccine communication may be the way to reach people with concerns — especially those who are less swayed, or have limited access to, medical professionals quoted in media and online, says marketing expert Monica Labarge.

The vaccination promotion campaign "This Is Our Shot" has employed celebrities, including actor Ryan Reynolds and Olympian-turned-doctor Hayley Wickenheiser, in an effort to reach Canadians who may not be connecting with expert advice.

"The thing I love about this campaign is it's reaching a totally different audience who may be vaccine hesitant, and for whom hearing from people who they feel like they have a connexion with that existed before the pandemic may be more convincing to them," said LaBarge, an assistant professor of marketing at Queen's University. 

She also applauded the campaign for publishing vaccine information that addresses common questions and concerns in 27 different languages.

"It's recognizing that there's a group of people who are not being reached by this traditional messaging that we're getting through the English language and French language media," she said.

Goldenberg says that health officials and experts could help further shed vaccine hesitancy by narrowing in on people's specific worries, adding that many see current messaging as overly broad.

"I say listen to the concerns and try to speak to them. I know in public communications around any crisis, there's that worry that if you admit to uncertainty, then the public is going to panic," she said.

"Trust the public to deal with uncertainty — we've been doing it all along — and give straightforward information without the confusing rhetoric around."


Written by Jason Vermes with files from The Canadian Press and Steve Howard.

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