‘Vaccine Ambassadors’: course teaches scientific facts to counter fear of childhood immunization

Since the US began vaccinating the 5-11 age group against Covid-19 in early November, about 8 million American children have been immunized with at least one dose.

It is from the immunization of this group that some of the most extensive studies on childhood vaccination have emerged so far, indicating safety and the very low rate of side effects.

However, full vaccination, with two doses, only reached 19% of American children in this age group. According to research by the Kaiser Family Foundation, with data from the Center for Disease Control (CDC), childhood vaccination in the US peaked in November, then dropped and then stopped at levels considered low.

For comparative purposes, Brazil, which started vaccinating the public from 5 to 11 just a few weeks ago, with Pfizer and CoronaVac, has already immunized around 3 million children with the first dose, or 15% of that population, according to the consortium of press vehicles based on information from state secretariats.

In an attempt to use scientific data to counter vaccination hesitation that encompasses a significant portion of the American population, Johns Hopkins University created a free online course that trains “vaccination ambassadors” in two hours of classes – who can be parents, educators or community members – able to talk about basic points of childhood immunization and to welcome “with empathy and respect” the doubts of parents “who are still hesitant about vaccinating their children”.

Some of these questions will be answered throughout this report, also based on data provided by Johns Hopkins or other scientific institutions.

In Brazil, a survey conducted by Fiocruz pointed out that the main reasons that lead parents to hesitate about immunizing their children are fear of adverse reactions and supposed long-term effects, minimization of the severity of the pandemic in children and the false idea that whoever had Covid-19 you don’t need to vaccinate yourself, because you have “natural immunity”.

The Johns Hopkins course, currently only available in English, has trained 3,522 “vaccine ambassadors” by February 1st, the university informs BBC News Brasil.

“The objective of the course is to empower more people to communicate with parents who have concerns about vaccinating their children, despite the availability of safe, effective and free vaccines against covid-19”, says the institution in a statement.

“In recent weeks, hospitalizations of children for Covid-19 have jumped to record levels (in the US), including among children aged 5 and over who are already eligible for vaccination.”

‘Active listening’ and ’empathy’

The first lesson of the course is the importance of “active listening”, with empathy and without judgment, to parents who are unsure about vaccination, without belittling their arguments or concerns.

“You can make a big difference when you give people a chance to talk about their concerns and when you offer science-based information to help answer their questions,” begins the training, which was created by Rupali Limaye, director of behavioral science at the Center Johns Hopkins International Access to Vaccines.

Some of the strategies proposed by the course “that research shows are useful in vaccine conversations” are:

– “Normalize” vaccination: human beings do not make decisions based only on data, but also based on what the circle of people around them does. Sharing vaccination photos or reporting how many school children have already been vaccinated, for example, helps make childhood vaccinations a “social norm” – something that is considered acceptable within a certain group.

– It is counterproductive to fight against arguments based on fake news or myths. The best way is to listen with your full attention, say the professionals at Johns Hopkins, and try to migrate the conversation to real, concrete, science-based facts (see more tips at the end of this text).

– Show empathy for those who are in doubt, with questions such as: “How do you feel about this? How can I help you solve those doubts? What would help you make a decision?”

And, in the second hour of the course, consistent scientific information is offered to help the interlocutor answer these uncertainties. Here are some of them:

Were vaccines produced ‘very quickly’?

One of the great fears about the safety of vaccination is due to the perception that vaccines against Covid-19 were produced too quickly, which would make it impossible to guarantee their safety.

In fact, the course clarifies that no safety or efficacy testing steps were skipped during the research for Covid-19 vaccines, and all these phases were overseen by regulatory bodies such as the US drug agency (FDA).

What happened, in the case of Covid-19 vaccines, is that, thanks to the urgency of the pandemic, steps that previously took place one at a time could occur simultaneously, saving time.

In addition, vaccines against Covid-19 – which in normal times would have to wait in a line of medicines until their turn to be analyzed by regulatory bodies – were placed at the very beginning of the line.

Finally, the scientists point out that the technology behind vaccines is not new – on the contrary, it has been around for decades. Science already had at least 20 years of accumulated knowledge about previous coronaviruses (from SARS and MERS), so they didn’t start from scratch with Sars-CoV-2.

Specifically about the mRNA technology, from Pfizer’s immunizer, the course explains that this vaccine teaches our cells to produce a piece of the so-called spike protein of the coronavirus, to alert our immune system to react if it encounters the virus.

But this vaccine has no effect on our DNA. And the vaccine doesn’t stay in our body for long: it is processed and dissipated in a matter of hours or days, says the course.

What about “toxic ingredients” in vaccines?

In fact, the university explains, ingredients like aluminum can be toxic, but only when ingested in amounts much higher than those present in vaccines.

In fact, vaccines have less aluminum than what we are exposed to in our daily lives, says the course.

What about the long-term effects of vaccines?

Johns Hopkins points out that no vaccine in the global immunization programs is related to long-term effects, not even fertility or reproductive problems.

In the case of the covid-19 vaccine, one concern of parents has been myocarditis, an inflammation of the heart muscle. Let’s get to the facts:

An analysis by the US CDC says that after more than 8.7 million infant doses of Pfizer were administered in the country, the immunization surveillance system received 4,200 reports of adverse effects in the 5-11 age group. years old. Of this total, almost 98% were not serious effects.

Of the effects considered serious, there were 15 preliminary reports of myocarditis, of which 11 could be verified – seven children had recovered and four were recovering at the time the report was made.

Here in Brazil, Fiocruz stated that most rare cases of myocarditis were in men in their 20s and 30s. In children, such conditions, in addition to being very rare, are mostly mild and treatable.

“It is important to emphasize that due to the low frequency of this adverse effect and the benign nature of the clinical presentation in the reported cases, the benefit of vaccination greatly outweighs the small risk of this complication”, says a technical opinion from Fiocruz.

That’s because Covid-19 itself can cause myocarditis.

See the difference: the risk of young men developing heart problems from Covid-19 is about 2.3%, according to a study cited by Johns Hopkins.

The risk of post-vaccination myocarditis is about 0.000095%.

The most common, in the case of vaccination, are still mild side effects, such as pain and discomfort in the arm, fever or fatigue. “These effects are temporary and mean your immune system is getting ready to fight a real Covid-19 infection,” explains Johns Hopkins.

Can you bet on ‘natural immunity’?

The Johns Hopkins material teaches that our immune system is made up of many different cells, which protect us as they learn to identify and fight invading pathogens.

One of the most effective ways to combat this is to create a “memory” about this pathogen. And anyone who has had Covid-19 or has had a vaccine most likely created this memory in their immune system.

However, this memory can only be temporary, especially in the case of someone who has already been infected. Recent studies have shown that immunity gained from the vaccine lasts much longer than immunity from infection – in practice, unvaccinated people are more than twice as likely to be reinfected by the coronavirus as fully vaccinated people.

And why do we need so many doses?

The course explains that the vaccine is like a school, in which the first dose is a kind of literacy of our immune system, and the second dose and the boosters are the following series – giving an additional training to the body, especially in the face of variants viruses to which we are most vulnerable.

Booster shots provide up to 75% more protection against symptomatic omicron infections, the university points out.

Why vaccinate children, if childhood cases of covid-19 tend to be milder?

A small percentage of children suffered from hospitalizations or severe cases of covid-19, compared to adults. But the absolute numbers show that children are also at risk, especially in the face of more aggressive or contagious variants.

Brazil accounts for 1,449 deaths of children aged 0 to 11 years since the beginning of the pandemic, points out a technical note in Conass (National Council of Secretaries of Health).

And more than 23,000 children have been diagnosed with Severe Acute Respiratory Syndrome (SARS), which is caused by Covid-19.

There were also 1,400 confirmed cases and 85 deaths of children aged 0 to 19 years from Pediatric Multisystem Inflammatory Syndrome (P-SIM), a rare but dangerous syndrome associated with Covid-19.

Finally, there are the risks of children developing so-called long Covid: long-term post-covid effects that are not yet fully understood by doctors.

And the child audience is being, at this stage of the pandemic, proportionally more affected by Covid-19, since the adult population had the chance to get vaccinated earlier.

In the US, in early January, an average of 672 children under age 17 were hospitalized each day with Covid-19, according to the CDC.

In other words, the data point out that the idea that the risks of the vaccine would be greater than those of covid-19 in children is a fallacy.

And when people argue using anti-vaccination fake news?

The Johns Hopkins course also teaches some warning signs against fake news related to vaccination.

Disinformation usually gains traction on social networks because it appeals to strong feelings: it causes us fear, anger or revolt, points out the university. It also tends to rely on “false experts” – people who don’t really have enough authority in infectology or who don’t have the backing of scientists.

Moments of uncertainty and excess of information like the current one are also fertile ground for conspiracy theories, which bring simple explanations to complex events and create “enemies” or “scapegoats” for their audience.

To react to arguments based on fake news, the university suggests:

• Offer a hard fact with scientific data
• Respectfully clarify the misinformation: “it is a common myth to think that….”
• Reinforce the original fact.

This tends to be more helpful than attacking the speaker’s beliefs, being condescending, simply saying he’s wrong, or belittling his sources of information, the university says.

The full Johns Hopkins University course is available on the Coursera platform, free of charge, in English.