Addressing vaccine hesitancy in Europe

Project Information

VAX-TRUST

Grant agreement ID: 965280

DOI

10.3030/965280

Project closed

EC signature date 18 January 2021

Start date 1 March 2021

End date 29 February 2024

Funded under

• SOCIETAL CHALLENGES - Health, demographic change and well-being

Total cost

€ 2 971 675,00

EU contribution

€ 2 971 675,00

Coordinated by

TAMPEREEN KORKEAKOULUSAATIO SR
Finland

Periodic Reporting for period 2 - VAX-TRUST (Addressing vaccine hesitancy in Europe)

Reporting period: 2022-09-01 to 2024-02-29

Summary of the context and overall objectives of the project

Addressing Vaccine Hesitancy in Europe (VAX-TRUST) was a 3-year research project committed to improving the understanding of vaccine hesitancy among healthcare professionals (HCPs) in Europe. Vaccine hesitancy is especially an issue in parts of Europe where vaccine rates continue to be lower than might be expected despite the availability of services.

VAX-TRUST aimed to a) conduct social scientific and context-sensitive research on vaccine hesitancy in specific regions, b) support HCPs and parents in their engagements with vaccine hesitancy, c) draw recommendations for addressing vaccine hesitancy on different policy levels.
Our findings confirm that a nuanced understanding of vaccine hesitancy needs to be grounded in the historical, political and socio-cultural context in which it occurs. Parents’ vaccine perceptions and decisions to vaccinate are affected by broader societal factors, such as level of trust in societies, healthcare system factors and structure (such as the level of corruption in the healthcare system), organization of immunization activities, institutionalization of preventive lifestyle, and degrees of institutional trust. Vaccine hesitancy is deeply intertwined with societal discussion on vaccines. Vaccine hesitancy is not based on ignorance or lack of knowledge. Parents have their reasons for decisions to vaccinate or not; these reasons need to be respected by HCPs. Building trust is key to encountering vaccine hesitancy.

VAX-TRUST highlighted that European HCPs have difficulties in addressing vaccine hesitancy. They need support with vaccine hesitancy encounters. VAX-TRUST supported HCPs with educational events, workshops and e-learning resources (reusable learning objects, RLOs) designed, implemented and evaluated in seven countries.

VAX-TRUST recommendations emphasize the importance of vaccine encounters that are sensitive to the physical, emotional and informational needs and unique agency of parents and children in decision-making around vaccines. Healthcare organisations and authorities need to ensure that training, peer support and organisational/institutional mechanisms are available for HCPs to foster the development of collaborative partnerships between HCPs and vaccine hesitant parents and children. VAX-TRUST recommends that HCPs involved in discussing childhood vaccines with parents increase their familiarity with the social scientific perspective on vaccine hesitancy.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

With an ethically sound approach, we examined individual, socio-demographic and macro-level factors of vaccine hesitancy, analysed media coverage on vaccines and collected interviews with 160 parents and 171 HCPs and 465 hours of observations. We developed and evaluated interventions, engaging about 400 HCPs in in-person educational sessions, about 300 in online sessions, and reached an additional 950 HCPs and stakeholders with RLOs, which remain in use. We exploited results to 520 medical and 700 nursing students through educational events and 200 nursing students via RLOs. We produced educational materials, such as RLOs, podcasts, games and publications (vax-trust.eu). We disseminated results through scientific journals, magazines and conferences.

We identified healthcare corruption and societal trust as key macro-level factors influencing vaccine attitudes. We also found significant individual-level interactions between gender, education, and number of children affecting vaccine perceptions. Cross-level interactions were noted for views on vaccine effectiveness and importance, underscoring the need for an intersectional, macro-sociological approach to studying vaccine hesitancy.

We revealed diverse vaccine discourses which people making vaccine decisions encounter, both intentionally and accidentally. They utilize various sources that influence and moderate vaccine-related controversies, involving political, financial, technological, and scientific factors.
We highlight the critical role of trust-building relationships among children, parents, and HCPs. We identified effective strategies for engaging vaccine-hesitant parents, who often feel criticized, and their autonomy violated in discussions with HCPs. While some HCPs felt confident in addressing vaccine hesitancy, many expressed uncertainty on the appropriate communication and actions in such encounters.

We underscore that vaccine discussions consider the physical, emotional and informational needs of both parents and children, advocating for decision-making that includes their unique perspectives. Healthcare organizations should provide training, peer and formal support to help HCPs develop skills to address vaccine hesitancy.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

VAX-TRUST has improved understanding of the underlying reasons for vaccine hesitancy, increased awareness on the topic among HCPs and facilitated their abilities to address vaccine-hesitancy. Ultimately, this new understanding may contribute to increased vaccination rates and improved public health outcomes.

VAX-TRUST contributed to novel healthcare practices to be developed by strengthening HCPs expertise to meet vaccine hesitancy. VAX-TRUST in-person training sessions and exploitation activities facilitated peer support which is important in generating a culture of well-being and satisfaction at work for HCPs. These contribute to better equipped HCPs to meet societal challenges related to expert knowledge, expertise and evidence-based recommendations, of which vaccine hesitancy is one.
As a result of our work, healthcare students will be more aware of the complexity of vaccine hesitancy. VAX-TRUST activities may have fostered creative practices within healthcare education. Further, engaging in VAX-TRUST activities where HCPs and future HCPs have been able to reflect their role in immunization activities could help mitigate vaccine hesitancy in the future.

VAX-TRUST has been engaged in capacity building by strengthening social scientific and public health knowledge of HCPs and future HCPs. By stimulating dialogue between researchers with diverse backgrounds, HCPs, parents, healthcare authorities, and healthcare organisations, VAX-TRUST has produced readily implementable evidence-based recommendations to European, national and regional public health authorities and healthcare systems, which can make a change in the encounters concerning vaccination towards family-friendly and customer-oriented practices, ultimately influencing health behaviours and vaccine coverage rates.

VAX-TRUST developed a new kind of design and evaluation process for interventions and training of interventions’ evaluators. We pioneered a collaborative approach between social scientists and public health scholars. We increased researchers’ capacities to exploit research results to various audiences in publications, interventions and educational activities. We also built capacities within the VAX-TRUST team by training and supporting early career researchers and female scholars. We have broken barriers in understanding between countries and improved understanding of research cultures across Europe.
Finally, VAX-TRUST has disseminated and communicated its findings across different EU projects and dialogued with WHO and the ECDC to disseminate the recommendations produced. This fosters collaboration on vaccine hesitancy of which the VAX-TRUST Final Conference in February 2024 was a prime example.

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