Motivational interviewing: A powerful tool to address vaccine hesitancy

Abstract

According to the World Health Organization, vaccine hesitancy is among the top threats to global health and few effective strategies address this growing problem. In Canada, approximatively 20% of parents/caregivers are concerned about their children receiving vaccines. Trying to convince them by simply providing the facts about vaccination may backfire and make parents/caregivers even more hesitant. In this context, how can health care providers overcome the challenge of parental decision-making needs regarding vaccination of their children? Motivational interviewing aims to support decision making by eliciting and strengthening a person's motivation to change their behaviour based on their own arguments for change. This approach is based on three main components: the spirit to cultivate a culture of partnership and compassion; the processes to foster engagement in the relationship and focus the discussion on the target of change; and the skills that enable health care providers to understand and address the parent/caregiver's real concerns. With regard to immunization, the motivational interviewing approach aims to inform parents/caregivers about vaccinations, according to their specific needs and their individual level of knowledge, with respectful acceptance of their beliefs. The use of motivational interviewing calls for a respectful and empathetic discussion of vaccination and helps to build a strong relationship. Numerous studies in Canada, including multicentre randomized controlled trials, have proven the effectiveness of the motivational interviewing approach. Since 2018, the PromoVac strategy, an educational intervention based on the motivational interviewing approach, has been implemented as a new practice of care in maternity wards across the province of Quebec through the Entretien Motivationnel en Maternité pour l'Immunisation des Enfants (EMMIE) program.

Factors that influence vaccination decision-making among pregnant women: A systematic review and meta-analysis

“…However, our study has demonstrated that factors specific to the vaccine, perhaps more so than the disease are highly influential. Interventions recommended to improve maternal vaccination uptake have ranged from text reminders for prospective mothers to educational videos and motivational interviewing techniques for HCPs [ 110 – 112 ]. Based on the results of this review, interventions designed to impact maternal vaccine uptake should continue to encourage individualised HCP recommendations.…”

“…Seasonal influenza vaccine was the most commonly investigated vaccine, either independently or as part of a study of factors influencing the uptake of multiple vaccines (63% of studies n = 75), followed by vaccines against pertussis (27% n = 32), pandemic influenza (24% n = 29), tetanus (8% n = 9), and antenatal vaccines generally (2% n = 2). We identified eight categories of factors that influence maternal vaccination across both qualitative and quantitative studies: accessibility and convenience (55 studies), personal values and lifestyle (43), awareness of information regarding the specific vaccine or disease of focus (90), social influences on vaccine use (109), emotions related to vaccination (85), perceptions of vaccine risk (110), perceptions of vaccine benefit (93), and personal vaccination history (80). From these eight categories, five could be synthesised quantitatively (Appendix p40-41 in S2 File).…”

Influenza Vaccination Quality Improvement as a Model for COVID-19 Prophylaxis

“…Several strategies have been implemented in vaccination efforts over the past decades with variable levels of patient engagement and success. Across diverse patient populations, motivational interviewing as a patient-centered communication style has been an effective method of improving vaccination rates as the conversation is centered around the patient and provides a respectful and non-judgmental setting to explore possible concerns [ 24 ]. An additional benefit of motivational interviewing is that it further enhances the patient-doctor relationship, as poor rapport/connection has been demonstrated to negatively influence vaccination choice [ 24 ].…”

Vaccine Hesitancy in Rural Pediatric Primary Care

“…The most commonly cited interventions identified in the literature include presumptive language models, motivational interviewing, and educational dialogue-based interventions ( Ames, Glenton, & Lewin, 2017 ; Eller, Henrikson, & Opel, 2019 ; Harvey, Reissland, & Mason, 2015 ; Jacobson, St. Sauver, Griffin, MacLaughlin, & Finney Rutten, 2020 ; McClure et al, 2017 ; Salmon et al, 2015 ). Interventions based on information deficit models that assume misconceptions are due to a lack of knowledge—indicating that the solution is to provide more information—have been disproven to change the minds of VHC effectively and have even shown an increase in VH rates ( Gagneur, 2020 ; McClure et al, 2017 ; Salmon et al, 2015 ).…”

“…Current studies have reported that presumptive language models and motivational interviewing techniques are consistently the most effective interventions to address VH and increase vaccination rates ( Gagneur, 2020 ; Jacobson et al, 2020 ; McClure et al, 2017 ). When providers used the presumptive language model in vaccine discussions, it strengthened the recommendation by offering a matter-of-fact approach and shared confidence in the provider recommendation.…”