Professor Michael Edelstein: Measles outbreak and the trust gap in vaccines

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A new Bariland study shows a global decline in parental
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trust and vaccines since COVID nineteen. In this episode, I
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sat down with Professor Michael Edelstein to talk about the
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impact of this study and what he found in his research. Okay, so,
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Professor edelsiin thank you so much for being on the show.
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Before we get started, I would love you could introduce
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yourself a little bit and kind of tell our audience
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who you are and.
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What you do. Sure, thank you very much for having me.
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So I'm a professor of public health at barry Land
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University and by background, I'm a medical doctor specialized in
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vaccines and vaccine programs, trained in the UK and working
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here in Israel.
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So you've worked in public health both in Israel and
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in the UK. From that experience, what made you want
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to look about how the pandemic has affected parental trust
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in vaccines.
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So in the very early days of the COVID pandemic,
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what we saw was disruption of the health system in general,
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with the vaccine program in particular, with you know, people
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having difficulty accessing clinics, being scared of going to the
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doctor because of fear of infection. So we saw large
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decreases in uptake of vaccination, and as the pandemic was receding,
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we saw vaccine update going back up, but not quite
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to what it was before. So I was very interested
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in understanding the more long term effect, not the immediate effect,
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but the more long term effect, because we know that
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when there are crises, the impact is very long lasting.
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And there's a very famous example from the UK where
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in the late nineteen nineties there was a scare of
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a link between autism and the MMR vaccine and that
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effect lasted for years really before the program recovered. So
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there's a need to look at this more long term
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effect of crises on vaccine programs.
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Kind of things. Can you say that you learned in
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general from the data?
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So what we learned. What we did in this study
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was to look at parents who have several children, at
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least one born before the pandemic and at least one
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born after, and we wanted to see whether their behavior
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changed or not before and after the pandemic, meaning if
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they vaccinated their children before, are they still vaccinating their
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children born after the pandemic.
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And what we saw was that.
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About five percent of parents who were vaccinating their children
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prior to the pandemic didn't vaccinate it didn't vaccinate their
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children born after the pandemic.
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And we did this in two countries.
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We did this in Israel and in the UK, and
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we found very very similar results.
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Which is a drop, right, It's a drop.
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So five percent might not sound huge, but actually when
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it comes to infection diseases.
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In particular, particularly.
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Very infectious diseases like measles, five percent is more than
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enough to trigger an outbreak. And this is what we're
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seeing now here in Israel.
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As someone with a medical background and also knowing how
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significant that number could be, what are your sort of
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messages that you give to people who, let's say, you
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know now they do have more hesitancy towards getting the vaccine,
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or they you know, they've changed kind of the way
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that they think. I think when people have that feeling
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and you know they've they've done their own research and
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they feel very confident in their views, sometimes you know
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they've lost trust in the medical system. How do you
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engage in that kind of conversation with people and parents specifically.
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It's a very good question and a complicated one to answer.
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I think one of the reasons we wanted to look
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specifically at the effect of the pandemic is because there
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were vaccines against COVID nineteen and a lot of confusion
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around these vaccines because they was very little time to
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bring them to the market, and there was also a
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lot of confusing guidelines and advice. So for example, in
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some countries, parents were told vaccinates to your young children.
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In other countries they were told not to, and that
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sort of, you know, eroded the trust that people have
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in vaccines. But with routine vaccines, it's very different because
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here we're talking about vaccines that are not new, that
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have been available for forty plus years. The first measles
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vaccine was available in nineteen sixty eight, the current vaccine
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combined MMR since nineteen eighty eight, so we have really
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decades of data, and the data is very clear that
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it's safe, that it's effective, and we know it's the
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best way to protect children. So my advice would be,
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you know, just to do the normal thing, the thing
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that people have done for generations. And I'm sure that
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parents today if they ask their parents or even their
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grandparents in some case and ask, I mean, did you vaccinate?
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Did you think twice about it. They probably will say no,
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of course not. We saw these diseases and speaking, I'm
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talking about measles because we have a tragic situation at
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the moment in Israel where eight children died in the
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last few months. We have situations where this particular disease
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was almost eliminated and is now coming back because because
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parents are vaccinating less.
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Yeah, I on the side note, I just like, it's
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very crazy. Every time I told you, every time I
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see a story like that, I I it's something that
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you know, when I was a child, it was almost
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that was the wording that they use. You know, it's
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something that's almost eradicated, and it's it's a different we're
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living in a different world almost. What do you find
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that parents seem to be most worried about and how
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really is how did the COVID situation kind of change
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their mindset? Not just because you know, there was differences
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in what different countries were saying, but how did they
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make that link between Okay, the COVID vaccine, which is
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something that's very fast, fast produced versus you know, measles.
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Things like that that you know that they you know,
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they've been tested, they've been.
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Tried, it's a good question. I'm not I don't know
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to what extent people considered different vaccines differently when it
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comes to their reasons. But we did ask specifically parents
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what worried them about vaccination, and the number one answer,
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both in the UK and in Israel was safety. They
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were concerned about whether the vaccine would be safe for
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their children, and the second choice was this. The second
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answer was that they didn't trust the system anymore. They
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didn't they they had a lack of trust in the
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healthcare system. So it wasn't about whether the vaccine works
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or not. It's whether it's safe, whether it has elements
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in it that are unsafe for children. Despite the fact
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that we know very well that you know the vaccines
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are safe because of forty years of data in multiple countries,
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that the reasons didn't really change and we did ask
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that as well. So it's not new that there aren't
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new reasons for not vaccinating or being unsure about vaccines,
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but the reasons that existed are just more prevalent now
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there are just more parents that that report them.
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Do you think social media plays a part in how
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people are being influenced?
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And yes, topic it's it's it's again, yes, I do
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think it plays a role a lot of people, and
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we do ask a lot about in this piece of
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research and in other pieces of research, we are lot
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about where people get information, and most people and again
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this is true in many countries, in several countries, and
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our research is conducted in israela in the UK, and
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in both settings, the first go to place for information
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is not social media. The first go to place is
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healthcare professionals websites from the Ministry of Health or the
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NHS in England. So most people do get their information
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from trusted sources, and people do know that social media
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is less reliable because there's no control over where the
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information comes from, whether it's valid or not valid. Nevertheless,
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there is a substantial proportion of people who do get
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their information from there. And as I'm sure you know,
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and most of the people who listen to this will know,
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you get all kinds of things, and misinformation is highly
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prevalent on social media networks. They misinformation travels very fast
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and it's much easier to spread than validated scientific information
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because all you need is one story or one claim
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that does not need to be substantiated, whereas if you
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want to put facts, and you want to put scientific evidence.
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It's a lot of work because you need to get sources,
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you need to substantiate your your your response. So the
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ability to respond is from the sort of the scientific
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community or the public health community is severely hindered. And yeah,
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you have all kinds of horror stories that may or
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may not be true that are influencing parents without a
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doubt if.
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We take I guess kind of like from the critical perspective,
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and I guess from people who you know, have changed
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their mindset or it was their mindset ready before the pandemic.
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I think a lot of people feel like they were
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kind of betrayed by the system in a lot of ways.
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I think, especially because COVID was such a crazy time
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and so much was unknown. A lot of people, you know,
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people lost people that they loved. They you know, people
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said that you know, they had reactions to the vaccine.
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Some people died because of reactions to the vaccine. There's
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so many different stories. How do you think that people
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can rebuild their trust with these systems.
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Yeah, it's a really it's an important point and I
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think we as public health professionals and health systems in
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general also need to reflect on how things are communicated,
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and things were communicated during this time. There's no doubt
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that there was a lot of confusion, and one thing
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we didn't maybe do is is communicate uncertainty, meaning when
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you have a and here i'm talking about the pandemic specifically,
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because you're in a situation where you need to make
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decisions very quickly and the data does not exist because
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there's no press and we don't really it's it's a
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virus that we don't know. We don't know, it's you know,
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there's just no there's just no data to make decisions
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that are one hundred percent sure. So we need to
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explain and we need to be transparent about uncertainty, to say,
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based on what we know and based on what we understand,
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this is, this is what we advise. The problem arise
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when things are communicated with certainty and then the advice
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is reversed or the advice changes. If you're a if
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you're a parent, you know, the first thing you think
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about is, well, these experts have no idea what they're
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talking about. So I think I think that's how we
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need to We need we need more transparency, we need
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and we need to acknowledge uncertainty and and and go
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through the process with.
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You know, go through the process.
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With with the collaboration with with more, with more communication
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with the public about how things move forward and how
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evidence and how data progresses through through a crisis.
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Do you think, sorry, do you think the vaccine was
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rolled out too quickly or do you think that you know,
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the kind of wasn't really a choice.
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I don't think the vaccine was rolled out too quickly.
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I mean, you know, again, there's there's a lot of
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stories on social media about you know, this is a
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giant guinea peag experiment and you know the testing things
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on us. This is not the case. There are you know,
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there are very vaccine. Vaccine production is one of the
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most one of the most highly regulated processes that you
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can imagine, and it was compressed as much as possible.
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But you know, it doesn't I don't think there was
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compromises on on on safety, on efficacy. What we didn't
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know was, you know, how long will the protection last,
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will it protect against infection, will it protect against severity?
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These things we didn't know. But there's no there's no
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scenario where you know, products are released without sufficient evidence
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that the vaccine is safe and effective.
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If we move now to more towards the measles outbreaks
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that have been happening specifically in Israel and related to
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the data that you know you've seen, where do you
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see it going in the future. Do you see and
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it's not very positive, but do you see it getting
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worse before it gets better?
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So measles is generally the first disease when you have
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decreases in vaccine coverage in the in the in the
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routine program. There's a lot of vaccines in the program
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that protect against a lot of diseases. Because measles is
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the most contagious. When the uptake of vaccination drops, it's
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the first diseases, the first disease to spread. And that's
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why we're seeing this now. The if the trends continue,
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we'll see unfortunately more measles, but also other diseases that
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will start emerging again, diseases like potassis, hooping cough, diseases
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like polio, and we're already seeing some of these. There
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were last last year or the year before, seven cases
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of infection with polio in Israel, and there was a
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potassis outbreaker, hooping cough outbreak in Jerusalem in I think
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twenty three or twenty four, remember hearing about So it's
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not and it's not confined to Israel. You know, there
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was recently polio discovered in sewage water in Germany, for example,
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So we'll see more outbreaks of more diseases in more places.
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Hence White surgeon to regain the trust of parents and
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reverse the trend.
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I think sometimes it also might be easier to maybe
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avoid what the real could be. So maybe could you
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go into a little bit about what it looks like
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when somebody actually catches the disease. I feel like that's
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important to go through.
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Yeah, so so if we talk about you know, one
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of the one of the reasons why many people don't
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vaccinate is because these diseases are not part of their
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everyday reality. You know, if you're going back to pre
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pre vaccination era, let's say you went to the nineteen
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forties or fifties, where you know, in England, for example,
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there were half a million cases of measles a year.
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Everyone knew people with that disease, and everyone knew someone
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who had lost a child or someone who knew someone
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who had lost a child. So it was much more real.
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Now it's not real. It feels like a theoretical risk
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with measles. It's an airborne disease, so people catch it
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from being in the same room, and because it's so contagious,
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minimal contact is enough. You can be sitting in the
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bus for five ten minutes next to someone who's incubating
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the disease before before that person even gets symptoms, and
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that's enough to make you infected, and it gives you
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a high fever, and it gives you a rash and
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you feel really unwell for a few days. And for
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most people, most people recover completely. It's not it's a
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mild disease for most people, but a significant minority do
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get more severely ill, have to be hospitalized and unfortunately die.
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And this year we've seen eight children dying out of
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about two thousand cases.
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And who's the most vulnerable A two actually contract the disease,
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and who's most vulnerable for it to be fatal.
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So there's really it's mainly a disease of childhood. The
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reason why adults get less infected is because they were
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vaccinating when they were children, so there's less susceptibility. There
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are less people who are susceptible to getting the disease,
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and older people were generally exposed when they were when
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they were children, so we're mainly talking about young children.
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People who are most at risk are people with underlying
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conditions with immuno suppression. Maybe they're on treatment for another disease,
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and that weakens their immune system and that makes them
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more prone to catching the disease and more likely to
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have more severe, more severe illness. So when you vaccinates,
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it's not just to protect yourself, but it's also to
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protect these individuals in our communities who are more vulnerable.
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Right, because some people, hey, they can't get the vaccine,
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right if you want to suppressed be I think people
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forget that there's like a like a collective responsibility because
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if you're making a personal decision, that's your personal decision.
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But what happens when your personal decision then affects, you know,
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vulnerable members of society. It's I know that it's a
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prevalent thing that people talk about. It's like the main
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thing actually that people will say, why do you think that?
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Sometimes that's not enough, Like you can say that and
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I could say here, or you could say here. You know,
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it's you have to think of others. You need to
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think of this, but it's not enough because like the
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is it the safety really of their children? They're thinking about.
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You know, I'm putting my child first and that's all
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that matters.
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So I think that's one of the most incredible things
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about vaccines is that when when you decide or when
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you decide for your child to be vaccinated, you not
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just protecting your own child, but you're also proticting other
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people and particularly vulnerable people in your community, in wider society.
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But of course as a parent, you know, I I
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always think that parents take decisions that they think are
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best for their children. So whatever they decide, it's because
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they think that it's the best decision for their child.
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So someone who does not, who chooses not to vaccinate
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their child, it's not because they don't want their child
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to be protected, is because they think that the risks
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of vaccination outweigh the benefits. And I think that's the
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I think that's the reason. You know, people make a
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mental calculation, and if they have information that is maybe
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incomplete or maybe incorrect, the disadvantages look much worse than
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they are in reality, and they're scared it's not because
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they don't care about other people. It's not because they
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don't care about their child. Is because the opposite, because
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they worry about their child. And I think it's our
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role and the role of the health system in general,
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to reassure to make sure that people get the right information,
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but also that people can get vaccinated easily without any hassle.
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And this is another important aspect to talk about because
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we talk a lot about vaccine hesitancy, but it's not
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the only reason why people don't get vaccinated. There's also
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issues with access, with difficulties getting appointments, with insufficient time,
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with people having very busy lives. So our role is
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not just to combat misinformation, but also to create a
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system where people can easily get an appointment, get in
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and out without disrupting their lives, because if you make
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it complicated, people won't come.
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I think it's kind of like, you know how in
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schools standard for children to get vaccines. If it's approved,
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they get it in school and they kind of just
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have to line up and it's there for them. I
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wonder if it's something that could be done more like
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in an institutionalized way. But I also think that then
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people would worry that it's being sort of forced upon them.
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So it's kind of like a fine line to try.
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So, you know, when when we talk about vaccination now
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we take what is called a life course approach, which
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means that there are different vaccines that are given at
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different stages of life. And of course a school is
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a fantastic setting for vaccination because the kids are there.
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You know, it doesn't need extra effort from the parents.
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But so it's great for vaccines that are given in
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those years. For example, the second dose of MMR is
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given in Israel in Kitalef, HPV vaccines are given to teenagers.
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For other vaccines, it's more difficult because they are given
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in the first year of life, so the children are
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not yet in school. But there are other settings. For example,
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now we've there's a new vaccine against RSV, which is
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a type of respiratory infection that is given in hospital
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just after birth. So again it doesn't require extra effort,
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extra steps from the parents, and what you know, the
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whole one of the challenges VAXX of a vaccine program
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is to optimize the protection in the minimum amounts of visits.
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So it's very very carefully thought out to limit how
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many times parents have to come and now with measles,
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because it's so important, the Ministry of Health and Israel
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has started opening other places for people to come and
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get vaccinated, even without an appointment. So you can walk
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into your kupai, you can go to the tipatala, to
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the health clinic without an appointment, in places whether the
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virus is circulating, to make it again as easy as
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possible and as hassle free as possible.
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So just so people you know who are watching this
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can understand when you get because I think there's so
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much misinformation about vaccines that maybe like general questions, you know,
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that seems it seems to be that people should know
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the answers. Maybe they don't. But once a child is vaccinated,
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for example, against measles, are they protected for the rest
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of their life.
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So it really depends on the vaccine and different vaccines
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have different objectives. With measles, there are two doses, and
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at the moment, the first dose is given at twelve
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months of age and the second dose at six years
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of age, but there's flexibility around that. If you receive
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both doses, the effectiveness is very very high above ninety
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nine percent and it lasts for decades twenty thirty years
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at least, So some vaccines are pretty much lifelong. Some
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of them are more short term, but they're intended to
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be so. For example, the new RSV vaccine really only
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protects for one or two years, but that's all you want.
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Because the disease affects children in that age group, we're
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not so worried about all the children, so it really depends.
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But for measles, yes, if you get your two shots,
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you don't need to worry.
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And if the cases go up as the fear of
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the virus.
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And again it depends very much on the virus. So
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the measles virus is a very stable virus. There are
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different kinds, but broadly speaking, they don't really change and
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there hasn't really been a need to change the vaccine
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that much over the last thirty to forty years. So
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for measles, that's not a concern. Other viruses, like for example, influenza,
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the flu virus that changes all the time, and that's
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why you need to get vaccinated every single year. But again,
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if we're talking about the measles outbreak that is currently ongoing,
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if you were vaccinated in the past with two doses,
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or if you get vaccinated, you're basically you're basically okay.
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And there's no indication that me measles viruses are mutating
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or changing the way that we've seen with COVID or
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with influenza.
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Other specific strategies that you've seen work either here in
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israelle or abroad where institutions have been successful in speaking
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more at an eye level with parents and kind of
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explaining not necessarily convincing, but explaining the truth behind vaccinations.
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Yeah, so there are things that work very well in general.
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As I've said before, making vaccination as easy as possible
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is the key. Information is only part of the story,
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and I would say it may not even be the
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main part of the story. I'll give you an example
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from Israel and an example from the UK. In Israel,
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there's a situation that's really interesting and quite unique, and
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that's that we have about twenty popular twenty percent of
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the population that is Arab, and generally around the world, minorities,
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minorities that are disadvantaged tend to have lower vaccine coverage
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or lower vac seen uptake than the general population. In Israel,
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it's the reverse, the Arab population is the part of
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the population that has the highest vaccine coverage.
427
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And this is almost unique. And I'll tell you something.
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I'm part of a I'm part of a large research
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consortium with seven or eight other countries around around Europe,
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and this is so unusual that they actually this this
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group took the example of the Arab population in Israel
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as what we've called an empowering example, an example of
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a population that has managed to achieve high vaccine uptake
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despite being socio economically disadvantage. So why is that? And
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we we have some research so when we asked them,
436
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and you know, we went and essentially you know, interviewed
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people and and and collected data in this in this community.
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There are several reasons, and I think this is something
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that the Ministry of Health can credit themselves for. First
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of all, people feel comfortable and respected in the in
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the in the healthcare system, they have access to information
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in their own language. There's a lot of healthcare workers
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that are Arabic speaking, so there's immediately a feeling of
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being accepted, being comfortable receiving information that is relevant to
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your own background in a language that you're comfortable with
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with you know, maybe social and cultural references that are
447
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relevant to you. And that's really really that's really really key.
448
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And the other element that people highlighted is that in
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the Arab population, unlike in the Jewish population, vaccination is
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a no brainer. It's just something that you do. It's
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a normal thing that you do. You know, you have children.
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When they reach the age, you take them to you
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take them to the you take them to the clinic
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and you get them their vaccines and it's not something
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that you need to agonize about for too long. And
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that's not you know, that norm of saying vaccine is
457
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just a normal thing to do is extremely powerful and
458
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reinforcing that from the from the healthcare system is is
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something that really works. In the UK, there was a
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really interesting example with the ultra Orthodox population in London
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where there was something called co creation that took place.
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And co creation means really engaging the community, not you know,
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not sitting in your office and writing guidelines and advice,
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but actually going and meeting the community understanding what are
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the barriers, what are the difficulties that people face. And
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what happened was that the local health system there teamed
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up with the local chapter of Hatsala, which is entirely
468
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stuffed by ultra Orthodox volunteers, and they set up clinics
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in the community. They were actually stuffed by Hatsala members
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that people knew, and instantly that created a very different
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atmosphere where people walked in saw people that they could
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identify with and again, you know, speaking in a way
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that was culturally appropriate and comfortable, and that was extremely successful.
474
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It sounds like familiarity is really the key. I think
475
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when you're trying to speak to people like literally not
476
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in their own language, but also sometimes figuratively, it's very
477
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hard to make progress. So I want to ask you,
478
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on a more positive note, from your research and the
479
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research that you've done, what do you see as something
480
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that's hopeful. Is there a hopeful trend?
481
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I think there is hope, you know, there is this
482
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and with hindsight, the one thing that does give me
483
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hope is in nineteen ninety eight when this British GP
484
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called Andrew Wakefield published his paper.
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On MMR and autism.
486
00:30:16.400 --> 00:30:18.880
Maybe you're too young to remember, but I was one
487
00:30:19.200 --> 00:30:24.160
go one okay that led to a drop that was
488
00:30:24.240 --> 00:30:25.680
on a totally different scale.
489
00:30:26.119 --> 00:30:27.480
I mean twenty percent.
490
00:30:27.839 --> 00:30:31.200
You know, the faccing coverage went into the eighties and
491
00:30:31.240 --> 00:30:38.240
low seventies, and it actually took decades to recover, but
492
00:30:38.319 --> 00:30:39.079
it did recover.
493
00:30:39.559 --> 00:30:40.720
It does take a lot of work.
494
00:30:40.799 --> 00:30:45.039
You know, there's a saying that trust is long and
495
00:30:45.079 --> 00:30:49.720
difficult to build and easy and quick to lose. And
496
00:30:49.759 --> 00:30:51.559
I think we need to we need to embark on this.
497
00:30:51.799 --> 00:30:57.640
We need to embark on this trust building relationship with
498
00:30:57.839 --> 00:31:00.359
the communities that we serve. And you know, both in
499
00:31:00.440 --> 00:31:03.079
Israel and in the UK, we have diverse communities. We
500
00:31:03.160 --> 00:31:06.160
have you know here we have Arabs, we have ultra
501
00:31:06.240 --> 00:31:10.079
Orthodox Jews, we have non religious Jews, we have Drews,
502
00:31:10.119 --> 00:31:12.920
We have all kinds of different people and some are
503
00:31:12.960 --> 00:31:15.680
more engaged, some are less engaged, Some have higher trust
504
00:31:15.680 --> 00:31:18.799
in the system, some have less trust. We need to
505
00:31:20.279 --> 00:31:22.119
we need to engage the community. We need to get
506
00:31:22.160 --> 00:31:26.359
to know who these people are, why they make the
507
00:31:26.440 --> 00:31:29.920
choices that they make, and to work with them too.
508
00:31:31.599 --> 00:31:34.400
To overcome this. We also have and again this is
509
00:31:34.400 --> 00:31:35.519
from the research that we do.
510
00:31:36.039 --> 00:31:40.599
You know, from the health from the health system perspective,
511
00:31:40.599 --> 00:31:45.119
it's very easy to assume that everyone within a community
512
00:31:45.160 --> 00:31:47.839
is the same. So you know, you have Arabs and Haredim,
513
00:31:49.000 --> 00:31:53.319
and you know from the health system perspective, they appear
514
00:31:53.359 --> 00:31:55.720
in your data and they look the same. But you
515
00:31:55.720 --> 00:32:04.000
know someone who's likely time in Nebrak and maybe Breslav
516
00:32:04.079 --> 00:32:07.559
Raside Minsvat are completely different people, or a Druising the
517
00:32:07.559 --> 00:32:11.359
Golan and a Bedwin in the Negev. Different even in
518
00:32:11.400 --> 00:32:13.920
the same community. They don't necessarily have the same barriers.
519
00:32:14.200 --> 00:32:17.359
They don't actually necessarily have the same reasons or the
520
00:32:17.400 --> 00:32:21.440
same thinking for making the decisions that they make about
521
00:32:21.480 --> 00:32:25.160
health and about vaccination. And we need to understand them,
522
00:32:25.160 --> 00:32:27.640
We need to get to know them, and.
523
00:32:27.599 --> 00:32:28.200
We need to work.
524
00:32:28.279 --> 00:32:31.559
We need to work closely, build that trust and build
525
00:32:31.599 --> 00:32:37.039
a system where people are comfortable to come and where
526
00:32:37.079 --> 00:32:40.279
it's easy. And that's a challenge because you know, in
527
00:32:40.359 --> 00:32:45.000
Israel we have a rapidly expanding population and the health
528
00:32:45.079 --> 00:32:49.119
services are not necessarily catching up, they're not necessarily following,
529
00:32:49.319 --> 00:32:52.119
and in some parts of the country it's actually difficult
530
00:32:52.160 --> 00:32:55.240
to have an appointment, and if you get one, it's
531
00:32:55.240 --> 00:32:56.759
not going to be at a convenient time or in
532
00:32:56.759 --> 00:32:59.279
a convenient place. And if you get there, you know
533
00:32:59.319 --> 00:33:02.480
the nurse will have two three minutes for you, because
534
00:33:02.559 --> 00:33:06.240
there's so many kids, and if you come already not
535
00:33:06.400 --> 00:33:11.839
sure and you're not given any attention and you don't
536
00:33:11.880 --> 00:33:14.920
receive answers to the questions that you have, that does
537
00:33:14.960 --> 00:33:19.559
not exactly instill confidence. So there's also a need for,
538
00:33:20.440 --> 00:33:23.279
you know, a better resourced system, or at least a
539
00:33:23.319 --> 00:33:27.119
system that matches the population growth at the moment, we
540
00:33:27.119 --> 00:33:27.640
don't have that.
541
00:33:28.319 --> 00:33:29.799
I want to ask you maybe a bit more of
542
00:33:29.839 --> 00:33:34.599
a difficult question. But if let's say a parent came
543
00:33:34.680 --> 00:33:36.000
up to you and said, you know, I've heard what
544
00:33:36.039 --> 00:33:39.000
you have to say. I listened to an interview, I
545
00:33:39.039 --> 00:33:42.000
saw your research. I don't agree with what you're saying,
546
00:33:42.119 --> 00:33:44.240
and I can't get on board. What is your response
547
00:33:44.319 --> 00:33:46.799
to that, because I'm sure that there are many people
548
00:33:46.880 --> 00:33:49.680
who still feel that way, and it's such a personal
549
00:33:49.720 --> 00:33:50.160
cause for that.
550
00:33:50.319 --> 00:33:52.880
Yeah. So, you know, when.
551
00:33:54.799 --> 00:33:58.720
When we think about vaccine hesitancy, it's really a spectrum.
552
00:33:59.720 --> 00:34:04.000
There are people who will vaccinate no matter what, and
553
00:34:04.480 --> 00:34:07.000
you know, you don't really need to worry about them.
554
00:34:07.359 --> 00:34:13.079
There are people who are really deeply ideologically against vaccination
555
00:34:13.239 --> 00:34:16.920
and it's very very difficult to convince them.
556
00:34:17.800 --> 00:34:19.800
And most people are somewhere in the middle.
557
00:34:19.599 --> 00:34:21.960
Either closer to the you know, I will vaccinate or
558
00:34:22.000 --> 00:34:26.400
closer to the I will not. I'm coming back to
559
00:34:26.480 --> 00:34:29.119
a point that I made previously, which is I deeply
560
00:34:29.159 --> 00:34:35.119
believe that every parent makes the decision that they think
561
00:34:35.199 --> 00:34:38.280
is best for their child. So the one thing that
562
00:34:38.519 --> 00:34:45.480
I will not do is is blaming parents, because you know,
563
00:34:45.679 --> 00:34:47.320
like every parent, they love the child and they want
564
00:34:47.320 --> 00:34:49.360
to they want they want the best for them. And
565
00:34:49.639 --> 00:34:51.679
I will keep I will always keep the door open
566
00:34:51.760 --> 00:34:54.960
to say, I hear what you say. I know that
567
00:34:55.000 --> 00:34:59.039
it's a I know that it's a it's a difficult decision,
568
00:34:59.519 --> 00:35:01.360
and I know that there's a lot of there's a
569
00:35:01.360 --> 00:35:06.119
lot of you know, scary stuff out there. You just
570
00:35:06.199 --> 00:35:09.039
have to you just have to understand that some information
571
00:35:09.239 --> 00:35:14.400
is more reliable, some information is less reliable. I understand
572
00:35:14.400 --> 00:35:20.199
your decision today. My door is open if you want,
573
00:35:20.320 --> 00:35:23.000
you know, if you want more information, or if you
574
00:35:23.079 --> 00:35:27.039
change your mind, You're welcome to come back at any time.
575
00:35:28.599 --> 00:35:31.719
But there's only you know, there are people that you
576
00:35:31.760 --> 00:35:34.079
will not you will not convince, And most of our
577
00:35:34.119 --> 00:35:37.880
efforts is not on the small minority that are really
578
00:35:38.280 --> 00:35:41.760
you know, deep into anti vaccination and conspiracy theories.
579
00:35:41.480 --> 00:35:41.920
Et cetera.
580
00:35:42.400 --> 00:35:44.719
But people who are more hesitant, you know, who hear
581
00:35:44.840 --> 00:35:48.920
both sides of the story, and we give them, we
582
00:35:49.000 --> 00:35:52.840
give them the best information that we can. And I
583
00:35:52.840 --> 00:35:54.800
think one of the one of the things where where
584
00:35:54.800 --> 00:35:56.719
we're failing is.
585
00:35:58.719 --> 00:35:59.079
People.
586
00:35:59.119 --> 00:36:02.119
You know, most people will react emotionally. They don't react
587
00:36:02.360 --> 00:36:07.159
to facts, their react to stories. What you receive from
588
00:36:07.360 --> 00:36:09.960
social media or from friend is always you know, it's
589
00:36:10.000 --> 00:36:13.239
a little bit like restaurant reviews on Google. If everything
590
00:36:13.280 --> 00:36:16.440
goes well, you don't write, but if things go wrong,
591
00:36:16.519 --> 00:36:19.079
you want to complain. So you end up hearing a
592
00:36:19.159 --> 00:36:22.000
lot of negative story. You know, you'll hear about the
593
00:36:22.039 --> 00:36:24.440
child who had a terrible reaction to the vaccine or
594
00:36:24.440 --> 00:36:26.559
a child who had this. What you don't hear is
595
00:36:27.360 --> 00:36:30.960
the hundreds of thousands and millions of stories of children
596
00:36:30.960 --> 00:36:34.960
who got vaccinated and nothing bad happened, and they were
597
00:36:35.000 --> 00:36:38.400
protected and they went on with their lives, not being sick.
598
00:36:38.760 --> 00:36:42.280
And I think what we need to start doing as
599
00:36:42.320 --> 00:36:46.280
healthcare professionals is not just to give people facts and statistics,
600
00:36:46.280 --> 00:36:49.960
because these are very cold, sometimes they're difficult to understand.
601
00:36:50.039 --> 00:36:53.840
People don't have the patience. We need to share stories.
602
00:36:53.920 --> 00:36:57.199
We need to share stories of parents who went to
603
00:36:57.280 --> 00:37:01.840
the clinic. Everything went well, they were were received, they
604
00:37:01.880 --> 00:37:05.000
receive the vaccine. The nurse was kind, you know, gave
605
00:37:05.079 --> 00:37:08.960
the gave the child a sticker or or a lollipop. Afterwards,
606
00:37:09.360 --> 00:37:13.159
nothing bad happened and everyone was happy. Because that's actually
607
00:37:13.159 --> 00:37:16.599
the experience of the vast majority of parents. And we
608
00:37:16.639 --> 00:37:19.920
need to get better at storytelling and not just share,
609
00:37:20.199 --> 00:37:23.000
not just say oh, read that study, read that study,
610
00:37:23.119 --> 00:37:26.599
read that paper, but stories, you know, and today, I mean,
611
00:37:26.599 --> 00:37:29.880
I'm not a you're the communications expert, I'm not. We
612
00:37:29.960 --> 00:37:32.559
have so many ways of sharing stories, whether it's video,
613
00:37:33.159 --> 00:37:37.599
whether it's you know, by speech, by by animation, by
614
00:37:37.679 --> 00:37:38.480
whatever means.
615
00:37:40.280 --> 00:37:41.519
I think we need to get better at that.
616
00:37:42.199 --> 00:37:45.679
I think there's an importance to what you said, especially
617
00:37:45.719 --> 00:37:48.920
because I think a lot of times in the medical
618
00:37:48.960 --> 00:37:53.239
system people feel dismissed. It's like a universal thing almost
619
00:37:53.280 --> 00:37:55.079
that you can speak to anybody from any country in
620
00:37:55.079 --> 00:37:58.280
the world and some most of the time they're going
621
00:37:58.320 --> 00:37:59.679
to have a story where they feel that way. And
622
00:37:59.719 --> 00:38:03.199
I think by you saying, you know, a I'm not
623
00:38:03.239 --> 00:38:05.199
here to judge you, I'm not here to you know,
624
00:38:05.280 --> 00:38:09.639
say that this is a situation that, like I can
625
00:38:09.679 --> 00:38:11.039
tell you to do A or I can tell you
626
00:38:11.039 --> 00:38:12.920
to do B, but it's really you know, here is
627
00:38:13.000 --> 00:38:15.920
information that I have. I'm here to listen, I'm here
628
00:38:15.920 --> 00:38:18.639
to give advice if you'd like. And you know, these
629
00:38:18.639 --> 00:38:21.320
are the medical facts, and I think that's there's a
630
00:38:21.360 --> 00:38:24.239
lot of importance to that. So thank you so much
631
00:38:24.280 --> 00:38:27.360
for being on the show. You're welcome, and I hope
632
00:38:27.400 --> 00:38:30.280
that we get to have you on again and talk
633
00:38:30.320 --> 00:38:32.960
about more positive things with pleasure.