Understanding why anti-vaxxers stand against vaccination may help pharmacists develop strategies to remove barriers to immunization.

Recently, a team of researchers profiled the 4 types of anti-vaxxers in detail. Their “4-C model” summarizes the main drivers for patients refusing to get vaccinated: complacency, convenience, lack of confidence, and utility calculation.

“The convenience category is a key one for pharmacists to target, because they can remove some of the barriers to vaccination by, for example, providing the pneumococcal vaccine at 24/7 retail pharmacies or bringing flu shots to communities centers,” Study author Gretchen Chapman, PhD, a professor of cognitive psychology at Rutgers University, told Pharmacy Times.

Dr. Chapman added that pharmacists can also help target complacency.

“When interacting with patients for non-vaccination reasons, pharmacists have the opportunity to communicate the risks of infectious disease,” she said.

The study authors offered the following profiles and potential interventions for each of the 4 types of anti-vaxxers:

1. Complacency

Pharmacists can emphasize the disease risks and social benefits of vaccines to this group.

For example, the study authors highlighted previous research that found that there needs to be a 95% immunization uptake to achieve herd immunity in order to eliminate measles. Sharing this fact could entice complacent individuals to get vaccinated.

“It has been shown that the communications of such social (rather than individual) benefits from vaccinations increases the vaccination intention, particularly when the risk associated with vaccination is low and vaccination comes with low effort,” the researchers wrote.

2. Convenience

The price of a vaccine and a patient’s willingness to pay, as well as the location of a place that offers vaccines, language and health literacy, and appeal of immunization service can all affect whether or not an individual gets immunized.

Among patients who believe that vaccinations are an inconvenience, pharmacists can remove barriers, support self-control, and add incentives.

As community pharmacies are often easier to access than doctors’ offices, pharmacists can do their part to help spread awareness that they offer vaccines right in the pharmacy. 

3. Lack of confidence

These patients may be fearful of the safety of vaccines, distrustful of the competence of health care providers administering them, or suspicious of the motivations of policymakers who encourage them.

In contrast to the complacent or inconvenient anti-vaxxer profiles, this group has more negative associations with vaccinations. As the root of these negative connotations is misinformation, the study authors stressed that health care professionals must correct myths about vaccinations, including the disproven theory that vaccines cause autism.

4. Utility calculation

These individuals may either be “free-riders” who rely on others to get vaccinated, or they may be “fence-sitters” who refuse or cannot make a decision when considering the pros and cons of vaccination. 

For those who believe that the risks of vaccination outweigh its benefits, the most important thing to do is talk about the social benefits of vaccinations and add incentives.

Gain-framed messages have been more successful than loss-framed messages, the researchers added. They did not encourage using fear to persuade this group.

“Although it is important that public health agencies explain the risks that are related to vaccine-preventable diseases as well as to increase self-efficacy to overcome this threat by vaccination, creating fear for persuasive reasons is not advisable,” the researchers wrote.

They also suggested sharing the following tweets to spread the word about how to remove barriers to vaccination:

·         Why people don’t #vaccinate: complacency, convenience, confidence, calculation #vaccineswork #vaccine #protecttheherd 
·         When people don’t #vaccinate because of complacency, communicate the risk of disease
·         When people don’t #vaccinate because it’s inconvenient, remove barriers and add incentives
·         When people don’t #vaccinate because they lack confidence in vaccines, it’s important to correct myths #vaccineswork
·         When people don’t #vaccinate because the calculated risks outweigh benefits, emphasize the social good #protecttheherd