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Abstract
BackgroundCommunities with low vaccination rates are at greater risk during outbreaks of vaccine preventable diseases. Most Australian parents support vaccines, but some refuse and are often judged harshly by their community, especially during an outbreak. We sought the perspectives of Australian public health experts on the key issues faced when managing a measles outbreak in an area with high anti-vaccination sentiment.MethodsA measles outbreak scenario formed the basis of a 3-round modified Delphi process to identify key practitioner concerns in relation to parents/carers who don’t follow the recommended vaccination schedule. We surveyed a range of professionals in the field: policymakers, infectious disease experts, immunisation program staff, and others involved in delivering childhood vaccinations, to identify key priorities when responding to an outbreak in a community with low vaccination coverage.ResultsFindings indicate that responses to measles outbreaks in communities with high anti-vaccination sentiment are motivated by concerns about the potential for a much larger outbreak event. The highest operational priority is to isolate infected children. The two most highly ranked practical issues are mistrust from non-vaccinating members of the local region and combatting misinformation about vaccines. Trying to change minds of such individuals is not a priority during an outbreak, nor is vaccinating their children. Using media and social media to provide information about the outbreak and measures the public can take to limit the spread of the disease was a focus.ConclusionsOur findings provide a deeper understanding of the challenges faced during an outbreak and priorities for communicating with communities where there is a high level of anti-vaccination sentiment. In the context of a global pandemic, the results of this study also have implications for managing public health responses to community transmission of SARS-CoV-2, as COVID-19 vaccines becomes widely available.
Highlights
Communities with low vaccination rates are at greater risk during outbreaks of vaccine preventable diseases
Media coverage and public discourse surrounding recent vaccine preventable disease outbreaks such as measles and pertussis have tended to focus on vaccine refusal and the need for vaccination, rather than the immediate need for cooperation with contact tracing and isolation [37,38,39,40]
While the Prime Minister later backtracked on these comments, others have taken up the call for mandatory COVID-19 vaccination in Australia [44]
Summary
Communities with low vaccination rates are at greater risk during outbreaks of vaccine preventable diseases. We sought the perspectives of Australian public health experts on the key issues faced when managing a measles outbreak in an area with high anti-vaccination sentiment. The COVID-19 pandemic has highlighted that public health responses to an infectious disease outbreak are multi-faceted. The success of the response extends beyond the actions of public health professionals alone. The actions of the public, the responses and policies of institutions such as schools and preschools, the framing and reporting of the situation by the media, and politicisation of the issue, all play a role in the course and management of the outbreak. Illumination of the needs and priorities of the public health professionals responsible for managing an outbreak is vital to inform measures which might ensure the most helpful responses from the other implicated stakeholders. In a scenario where a preventive measure, such as a vaccine, is available, but not necessarily embraced by the affected population
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