Political Will, Public Confidence, and Immunization Impact: a few thoughts

Political Will, Public Confidence, and Immunization Impact:

Priorities, Policies, Perceptions panel Vanina LAURENT-LEDRU, Merck/ MSD Center for Vaccine Ethics and Policy Symposium 4 May 2011 Philadelphia

From

Evidence

to

Story telling

(Immunization Impact angle)

From the « best value in medicine » to suspicion and fear  Vaccines eradicated smallpox (1980) which previously killed 5 million each year (1)  Vaccines have virtually eliminated polio from Europe (2002) and have saved 5 million people from paralysis worldwide  … yet a Measles outbreak is hitting Europe, with most cases in France Vanina Laurent-Ledru (1) WHO website: WHO http://www.who.int/mediacentre/factsheets/fs114/en/index.html

Boundaries between facts and beliefs have become increasingly porous 

Perceptions around vaccination have been irreversibly damaged by a series of scare stories, "to an extent that no amount of evidence can change the public’s mind."

Margaret Chan, WHO, January 2011  Facts only are not enough to do the job and it thus appears high time to rethink the approach to communication more responsive to become to public concerns.  Concept of Storytelling Vanina Laurent-Ledru

Concerted efforts of

all

Stakeholders

(Public Confidence angle)

1970’s

Vaccinology is being radically transformed by the growth of health partners

End 1990’s End 2000’s Customers National Regulators Vaccine Industry Doctors Politicians EU regulators Health Insurances National authorities General Public Customers Vaccine Industry Investors Patients’gr Doctors Media Employees Academia Financial analysts Regulator-driven

Source: adapted from Novo Nordisk

Accountable to more & more stakeholders Driven by empowered stakeholders

Vanina Laurent-Ledru 7

A new category of influencers in vaccinology : Vaccines are only given to healthy people...

…but change of paradigm:  Patient groups are getting involved in vaccinology, via HPV vaccination  Until now, patient groups were only active on treatment level or secondary prevention issues (screening)  With HPV vaccination, it is also the 1st time that women associations are involved in vaccinology Vanina Laurent-Ledru

Civil Society Organizations can provide a bridge from the science to the lay public  Culture, language and politics drive public attitudes.  Need to go through “ Trust networks ” for successful education/ communication campaigns  CSOs often bring innovative and effective new approaches to communication on prevention benefits.  Estonian Emakas association social media campaign

"

with impact on traditional media http://www.youtube.com/watch?v=6S_tPoYJsAc&feature=related Vanina Laurent-Ledru 9

From

Education

to

Persuasion

(Political Will angle)

Communication should be an integral part of policy and planning   We must dedicate as much effort to communicating on vaccines as we do on providing them Classical media will continue to provide much of the interface between immunisation programmes and the public  Communication for vaccines, through classical and new channels, must be included budgets in national immunization Vanina Laurent-Ledru Adapted from Jo Yarwood

How to move forward: Increase health literacy at all levels of education



“Health literacy is the capacity to make sound health decisions in the context of every day life”

 …but in Europe & US, not enough  Groups at the higher end of socio economic ladder tend to be the most sceptical of vaccines Vanina Laurent-Ledru

S ørensen et al. (2010): Health literacy and public health: A review and integration of definitions and models. BMC Public Health (in review)

Sociobehavioral research

See Sturm &al. J Dev Behav Pediatr 2005 Bonell "one nudge forward, 2 steps back“ BMJ, 2011 Opel, Arch pediatr Adolesc Med 2009  Social norms predict both intention to be vaccinated and vaccination itself  Go beyond education into persuasion in public health campaigns, through social sciences  Call for more research to assess effectiveness and ethical impact of social sciences on vaccination • • social marketing peer education • • «nudging » and many others... Vanina Laurent-Ledru

In a nutshell

 Facts only are not enough to do the job  Perceptions , Attitudes , Values and Beliefs key to vaccination sustainable success  Paradigm shift needed implementation : for successful  Concerted and active efforts of all stakeholders  Move away from mere communication to behavioral change management…but at the same time becoming more transparent and responsive to public concerns Vanina Laurent-Ledru