Coming Together to Address Vaccine Hesitancy

As millions of Canadians prepare to participate in the largest vaccination program in Canadian history a significant portion of our population continues to have some doubts about vaccination itself or the current crop of vaccines designed to protect us from COVID-19. A January 2021 poll shows that 10% of Canadians do not intend to get a vaccine at all, with another 36% taking a wait and see approach.Canada's Chief Public Health Officer Dr. Theresa Tam has stated that 65 to 78 per cent of Canadians have indicated they would get a COVID-19 vaccine. Dr. Tam has also said that it is "critical" for public health to bring what she calls the "moveable middle," or undecided Canadians, onside.The World Health Organization says that it is still too early to tell what percentage of population needs to be vaccinated in order to achieve herd immunity against COVID-19. Herd immunity varies with each disease. Measles requires about 95% of a population to be vaccinated while polio requires 80%.What we do know is that focusing on vulnerable populations and convincing as many Canadians as possible to participate in our COVID-19 vaccination efforts is essential.At Perley Rideau, achieving high vaccination rates within our community is a core objective.  Over the years we have developed successful approaches to ensure that our vulnerable citizens are protected from influenza and brought many of lessons learned to our COVID-19 efforts. We care for 450 residents and bring together another 800 staff and hundreds of personal caregivers and volunteers.We have been able to achieve influenza vaccination rates of 96% for our residents and 91% for staff-.  Maintaining this high rate of compliance even in a community that largely embraces science remains an on-going challenge.We were very fortunate this year to be among the first Canadian LTC facilities to get COVID-19 vaccines. This was due in part to being a priority population, our ability to implement a vaccine program on short notice and our excellent track record on vaccination.The Government of Canada has pledged that every Canadian will have the opportunity to be vaccinated by September 30th2021.  The Government of Ontario is implementing an on-line system that will enable citizens to set up vaccine appointments. As we look to 2021 here are some of the Perley Rideau's key learnings to supplement the excellent advice that is available from Public Health Agency of Canada, Ontario Public Health and Ottawa Public Health.At your school or workplace, have a team devoted to vaccine promotion.  Build a culture. Look at all avenues to share vaccine information.  There is a lot of disreputable information in the public environment about vaccines and it is important to share information about their value throughout the year. All organizations have a role to play to promote the value of vaccines.Dr. Tam said the government is preparing a multipronged campaign to inform the public about it. That includes working with social media companies, such as Facebook and Twitter, and even gaming platforms. Look for opportunities to share information from public health authorities with your community.We have found that clear and simple messages work best. it is important to communicate early and consistently. Be respectful to your audience by acknowledging the questions individuals may have. Our goal is to inform but the individual must ultimately make their own decision. The exchanges with staff help inform the vaccination team and provide valuable information for the communications strategy.The notion of scarcity is also important, people will respond more positively if they believe that a product is in high demand or an opportunity is time limited.Make getting a vaccine as easy as possible is also important. The Perley Rideau has the benefit of size and trained staff to administer onsite and was able to provide the vaccine where people live and work. This will not be realistic with COVID vaccines being administered at central locations, but as a rule of thumb, the more convenient the process the higher the outcome. At the retail level, incentives work - like free coffee and donuts.At Perley Rideau we have also considered the value of requiring individuals to opt out of the vaccine. We have created a consent form which includes those declining to get a vaccine to state their reasons for opting out.Staff engagement on all perspectives is vital including the design of the declination form. This information can be used to inform educational materials get at concerns or can be addressed right then and there with a discussion that addresses their fear or anxiety.For instance, in COVID-19 some have questioned the speed that the vaccines have been produced and approved and question their safety. A discussion how Canada and many leading countries have robust regulatory process and have carefully monitored the data on vaccines can help provide comfort.Throughout the process, encourage as much feedback from people as possible and track the comments and observations that people are sharing. Be prepared to change your process or messaging as needed.Ambassadors and word of mouth are also essential. At Perley Rideau we ensure that staff and volunteers see their leaders get the vaccine. That is why photos of prominent Canadians and leaders getting the vaccines can provide a powerful endorsement and help reduce any concern.People are influenced by their peers so encourage people to share photos and resharing of others taking their vaccines.   Social media networks are essential to get the word out, encourage early adopters to become champions, to use their influence.Every Canadian has been impacted in some way by COVID-19.   As 2021 begins, there is light at the end of the tunnel. Every vaccine can help save a life. So please speak to your family, your friends and neighbors and share with them the role they can play to help us get to a post-COVID-19 world.Akos Hoffer is Chief Executive Officer of the Perley and Rideau Veterans' Health Centre.