How to talk to vaccine hesitant clients

Human medicine has seen a troubling rise in vaccine hesitancy in recent years; the World Health Organization (WHO) named vaccine hesitancy one of the top ten global health threats in 2019.

Then COVID hit, and vaccine hesitancy really ramped up.

Anecdotal stories suggesting that the human anti-vax movement had negatively impacted companion animal vaccination compliance rates were floating around pre-COVID, but a 2021 joint study by US and Canadian researchers was the first to try and see if there was correlation. And sure enough the researchers found a positive correlation between the number of vaccine resistant clients reported by veterinarians and organized anti-vax movements in their community.

NEWStat spoke with lead researcher Lori Kogan, PhD, a licensed psychologist and professor of clinical sciences at Colorado State University’s College of Veterinary Medicine.

Although the data from Kogan’s study predates COVID, she told NEWStat she launched the study because even pre-COVID, she was concerned about the growing anti-vax movement worldwide.  “We’re seeing more of it across the board, for animals and humans,” she said. “I think it’s going to continue to grow as an issue.”

The researchers found that there’s a lot less hesitancy about rabies vaccination compared to other core vaccines, and Kogan says there are a couple of reasons: “A huge part of that is the legal aspect.” Rabies vaccinations for dogs are mandated by law in most of the US and Canada, and most owners don’t have much of a problem complying with that. “There’s a pretty strong legal hand there.”

Another reason for rabies vaccination compliance is education—of a sort.

Kogan said most people have some understanding of the human consequences of not vaccinating pets for rabies, if only anecdotal. People tend to know the bullet points about rabies in humans—hydrophobia; agonizing death; the multiple, painful shots that people bitten by rabid animals used to have to endure. “My guess is there’s more common knowledge about rabies as opposed to, say, distemper— a lot of people may not even understand what it is or what the risks of non-vaccination are.”

But rabies?  “Everybody’s heard of it,” Kogan said. “The other things seem more nebulous.”

She said there are steps a veterinarian can take to try and help pet owners navigate their vaccination hesitancy. The first is to understand the reason or basis of their hesitation to vaccinate: “A lot of times it’s an emotional decision,” said Kogan; frequently, it’s a lack of awareness about the consequences of these diseases .  “[Sometimes] tOther times, they may view vaccines as unnecessary.

Kogan suggests giving them a little validation, and start by acknowledging those concerns.

Acknowledge that yes, there is a cost associated with vaccination, which can also carry the risk of side effects But more important, acknowledge that they’re concerned about their pet’s health, which is why they’re not ruling vaccination out. “In a situation like that, I’ll say to the client: ‘It sounds like there’s a way we can do this. We can either vaccinate or not. Let’s explore the possible effects of both of those decisions.”  

Then she’ll carefully explain what, for example, distemper is and what the risks are.

“I might say to somebody, ’I’m trying to imagine how you might feel if your dog got distemper and gets really, really sick.’”

Then she’ll talk about the consequences of not vaccinating—not to frighten but to educate: “I let them know that these are some real, tangible, potential effects of making a decision to not vaccinate.” Then she helps them think through potential scenarios and what those might look like. “Is that a risk that they’re willing to take?”

For vaccine hesitant owners who view vaccines as risky, Kogan said that veterinarians can help them see that—as with rabies—there are risks that come with not vaccinating.  Once you get clients to understand that “it becomes a matter of helping them weigh the consequences.”

She said this approach helps take the emotional charge out of the decision to vaccinate, and encourages the client to think of the veterinarian as someone who understands their fears and is working with them to achieve a better outcome for their pet: “I want us to think through this as a team.”

So are pet owners who are anti-vax when it comes to themselves automatically anti-vax when it comes to their pets?

Kogan said she doesn’t have data on that and would hesitate to make a guess, but adds that she’s long been interested in a lot of related health issues about people’s attitudes toward their own health and how that relates to their pets’ health. “They don’t always correlate,” she said, “And diet’s a good example. Some owners can be very healthy about what they eat, but they can’t resist feeding their dog a piece of pizza as a treat.”

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