Addressing vaccine hesitancy in Europe

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Addressing vaccine hesitancy in the training of healthcare professionals: insights from the VAX-TRUST project

Publication . Augusto, Fábio Rafael; Guerreiro, Cátia Sá; Morais, Rita; Mendonça, Joana; Beja, André; Correia, Tiago; Hilário, Ana Patrícia

Background: Evidence suggests that healthcare professionals often feel uncomfortable discussing vaccination with patients, largely due to a lack of training on the topic. In line with the scientific evidence gathered from the VAX-TRUST project, it is crucial to invest in training healthcare professionals and developing political measures to effectively address vaccine hesitancy. This paper explores the importance of training healthcare professionals to address vaccine hesitancy and provides concrete strategies for its implementation. Study design: A quantitative research design was used. Methods: The findings are based on a comprehensive Delphi survey conducted with a panel of 112 experts. Additionally, the study involved practical interventions carried out across seven European countries, engaging a total of 694 participants. These participants included general practitioners (GPs), paediatricians, nurses, as well as medical and nursing students. This robust and diverse dataset provides a well-rounded perspective on the subject matter, ensuring that the insights gained are both extensive and representative of various healthcare professionals across Europe. Results: Three key themes emerged from the findings: the need for effective strategies to address communication challenges with vaccine-hesitant individuals, the importance of using evidence-based communication practices to improve these interactions, and the necessity of integrating social scientific knowledge on vaccination into the training of healthcare professionals. Conclusions: Training healthcare professionals is essential to equip them with skills and knowledge needed to deal with the complexities of vaccine hesitancy. Evidence was gathered on ways to reflect and act to develop this capacity, namely, by increasing the ability to communicate empathetically, responding to patients’ concerns with evidence-based information, and to building stronger and more collaborative relationships with them.

2025Journal article

Open access

Implementação de um modelo de vacinação centrado na família [Brochura]

Publication . Hilario, Ana Patricia; Mendonça, Joana

2023Education resource

Open access

Recomendações dirigidas a profissionais, organizações e autoridades de saúde com o intuito de mitigar a hesitação vacinal em Portugal. Policy Brief

Publication . Hilario, Ana Patricia; Mendonça, Joana; Augusto, Fábio Rafael

Portugal é um dos países europeus com maiores níveis de confiança nas vacinas 1. A taxa de vacinação infantil [cortes até aos 7 anos de idade] tem registado valores estáveis e elevados [ � 95%] ao longo dos anos 2. O Programa Nacional de Vacinação [PNV], em vigor desde 1965, é gratuito e universal. Ao abrigo deste programa, todas as crianças residentes em Portugal têm acesso às vacinas recomendadas. Com a exceção das vacinas do tétano e da difteria, todas as restantes não são obrigatórias. Apesar da elevada cobertura vacinal, a população portuguesa não está salvaguardada da propagação de discursos anti vacinação, bem como dos seus efeitos nefastos 3. Em 2017, foram identificados dois surtos de sarampo nas regiões de Lisboa e Vale do Tejo e Algarve, sendo que estas regiões registam taxas de cobertura vacinal menores comparativamente à taxa média global do país 4. Isto demonstra, precisamente, a importância de estudar o fenómeno da hesitação vacinal mesmo em contextos onde o mesmo parece ser menos significativo.

2024Other

Open access

A Team Ethnography on Vaccine Hesitancy in Europe: A Case Study of a Local Truth Construction

Publication . Cardano, Mario; Numerato, Dino; Gariglio, Luigi; Hasmanová Marhánková, Jaroslava; Scavarda, Alice; Bracke, Piet; Hilario, Ana Patricia; Polak, Paulina

This paper focuses on the methodological conundrum of doing quick team ethnography in complex teams in a clinical setting studying childhood vaccine hesitancy. It describes how and to what extent a particular «thought style» (in Ludwik Fleck’s meaning) has developed through decisions, negotiations and disputes, producing a dialogical «local truth». It also shows how ethnographers can adapt their practice, considering day-to-day endogenous changes in fieldwork and public debate as well as exogenous ones, such as pandemics and wars. Following a compact exploration of a few sensitising concepts, referring in particular to Ludwik Fleck, Knorr-Cetina and Clifford Geertz, it explores how the complex team had worked in practice effectively while unpacking vaccine hesitancy. The paper describes three fundamental steps of this group endeavour: i) the genealogy of the birth of the team and the subsequent team-building process; ii) the illustration of how the group’s «thought collective» and interactions have produced in practice a «local truth»; iii) a reflexive stance on this particular empirical case of «method in process». The paper concludes with methodological remarks

2023Journal article

Open access

Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters

Publication . Lermytte, Esther; Scavarda, Alice; Hilário, Ana Patrícia; Gariglio, Luigi; Mendonça, Joana; Ceuterick, Melissa

Access to pain management is a human right. Nevertheless, research consistently reports that children’s pain is under-recognised and under-treated compared to that of adults. Additionally, younger children are less likely to receive treatment for their pain. The significance of early-life healthcare experiences is often underestimated due to constructions of young children as passive rather than active agents in healthcare. This study addresses this issue by examining how children’s agency is co-constructed within the triad of children, caregivers, and healthcare professionals during childhood vaccination consultations. Field notes were collected describing vaccination consultations involving children aged two months to seven years, with an overrepresentation of children under the age of two due to the study’s focus. Ethnographic observations (~275.5 h) were held in Belgium, Italy, and Portugal, due to their diversity in healthcare system characteristics, vaccination policy, and coverage. Data were analysed using template analysis, a specific type of thematic analysis. Findings illustrate that children inherently possess agency, which can be hindered or facilitated by caregivers and healthcare professionals in the healthcare setting. Although clinical guidelines on pain mitigation for paediatric vaccinations exist, the findings show that these are not consistently applied in practice. Providing a framework for understanding the variability in paediatric pain mitigation, we highlight the socio-cultural conditions by which young children are either socialised into the patient role, or have their status as patients undermined. In pursuit of quality healthcare and pain mitigation for children during vaccination consultations, it is necessary that they are considered and treated as active, embodied healthcare agents.

2025Journal article

Restricted access