COUNSELING AND VACCINE HESITANCY
All children should be assessed for their immunization status, preferably by reviewing their immunization card at every point of health care contact, even if they are sick or presented for different reasons.
Indirect clues, e.g. presence of scar, age and site of previous vaccinations, price paid for the same in private sector, etc. may be used to identify the vaccines received earlier, if required.A new card should be filled out, if the old immunization card is lost or not available, identifying all the vaccine/s the child needs now, including those missed earlier. Any recommended immunization schedule - NIS or IAP, may be used to customize individual vaccination requirements, with due considerations for contraindications or precautions.
Appropriate communication with parents is the key to let them appreciate the need for a vaccine and should provide information about:
• Potential risk of developing the disease or its complications.
• Efficacy of the vaccine must be informed in realistic terms. No vaccine is 100% effective and failures do occur but even then partial protection is expected to reduce the morbidity and complications.
• Safety of the vaccine must also be explained with risk of potential side effects. However, parent must be explained that benefits of vaccination outweigh the risk of side-effects and most side-effects are minor, transient and easily manageable.
• Cost of the vaccine is an important consideration for parents visiting private sector and should be informed in advance along with available alternatives. Parents should also be informed regarding free-of-cost availability of some vaccines under NIS.
Appropriate counseling will go a long way to alleviate parental apprehensions and ensure compliance. However, a written consent is not necessary before vaccination (IAP).
Vaccine hesitancy, i.e. the reluctance or refusal to vaccinate despite the availability of vaccines has been recognized as one of the leading threats to global health. WHO's Strategic Advisory Group of Experts (SAGE) defines vaccine hesitancy as an individual's behavior, influenced by the 3Cs Confidence, i.e. trust or no trust in the vaccine or provider; Complacency, i.e. perceived need or value of the vaccine, and Convenience, i.e. ease or difficulty of access. It is the duty of HCW to identify the reason/s for vaccine hesitancy in care-givers and allay their concerns.
9.8.2