Q&A With Karen Ernst, Director of Parent-Led Vaccine Confidence Program

The Task Force’s Voices for Vaccines (VFV) program is a parent-led initiative supported by scientists, doctors, and public health officials to provide parents clear, science-based information about vaccines and vaccine-preventable diseases, as well as foster discussion about vaccinations. VFV creates opportunities for parents to have positive conversations by sharing personal vaccination stories on their blog and hosting a  podcast about vaccine developments, both socially and scientifically.

In the U.S., VFV works with statewide immunization coalitions to engage family members of all generations because vaccines play a key role across the lifespan and because multiple family members inform in vaccine decisions. Globally, the team is working with the Centers for Disease Control and Prevention to develop training modules for peer-to-peer motivational interviews in low- and middle-income countries so  caregivers have resources to have positive vaccination conversations with their peers. 

VFV’s Director Karen Ernst a former teacher and mother of three, recently joined Chelsea Clinton of the Clinton Foundation, Anuradha Gupta of Gavi, the Vaccine Alliance, and Joslyn Prince, a student at Jarvis Christian College on a panel at Fortune’s Most Powerful Women Next Gen Summit to speak about vaccine skepticism.

Here, we asked her about her work and her approach to talking with parents.

Q: Vaccines are a controversial issue. Why do you think this is the case?

There are certainly lots of different parts to vaccine hesitancy and it’s not totally homogenous. I think what it comes down to is the way that we handle health decisions in general in the U.S. and that’s linked to our consumer culture because we see ourselves as people who have the right to make all the decisions about what we purchase, and healthcare is one of those purchases. So we make decisions about whether to vaccinate or not in the same way we do about choosing toothpaste or milk which are also health decisions, treating them like they are of equal importance, but they’re not. Sometimes we have to defer to experts when it comes to certain things about our health or our child’s health.

Q: What is your approach to addressing the concerns of a parent who is hesitant about vaccinating their child? 

I really think it is important that the first thing anyone does is be a good listener and to hold off on that urge to debunk or correct. There is often a genuine place that people’s hesitation toward vaccines is coming from so listening well enough to understand that concern is extremely important.

As an organization that provides opportunities to have these conversations, including listening to people’s questions and concerns, our responses often take place on a public platform. That means we’re not just talking to that one person who has that concern but to everyone else who might have similar concerns or hesitations, so you have to communicate in a way that is clear and transparent for many to understand.

It’s also important for public health experts who focus on vaccines and infectious diseases to remember that as knowledgeable experts who are well-respected they can make a mountain of difference in building awareness and addressing vaccine hesitancy. Even in their immediate social spheres, public health experts can talk to their friends, share information on their social networks and write letters to the editor that will make an impact in answering the concerns of non-experts like parents who want to make the best choice for their children. Especially in this time when we need to take back the meaning of expert, it’s important to be sharing concrete information.

Q: What’s an example of how you have that conversation? What kinds of things do you say? 

On our blog, we have a number of examples from parents themselves. One of those parents, Juniper Russo, recounts how her child’s pediatrician patiently and over the course of years kept bringing up vaccines and listening to her concerns until the day her unvaccinated daughter was diagnosed with autism. The pediatrician returned to the conversation with support and concrete information and evidence that vaccines were safe and effective.

Q: How do you think the parent-led aspect of VFV helps achieve VFV’s mission?

Before information was so easily accessible parents would save their questions for when they went to the doctor, but now people are talking among themselves and sharing information they find about vaccines with each other on social media and blogs. So parents’ questions and concerns are starting to be answered even before they go to the doctor, and we really wanted to meet parents where they’re seeking their information as parents ourselves. 

These conversations are happening and not just in the doctor’s office. They’re important conversations, and it is important for people who are against vaccines to know that they are not the only ones searching for clarity about vaccines. Having parents speak to other parents about their experiences and why they choose or don’t choose vaccines for their children helps make it more relatable. That’s why we started “Why I Choose” as a platform for people to share their vaccination experiences.

Q: How do you think the pandemic and the race for a COVID-19 vaccine is shaping the overall vaccine issue?

I don’t think we entirely know right now how much and which direction the public’s view of vaccines will go. People are definitely more interested in how vaccines are developed and that provides an excellent opportunity for public education because people are now willing to read an article about phase 3 of vaccine trials whereas before there was never that focus on vaccines. So if we can maximize this attention, that will echo for years to come. 

I am really impressed with the scientists in the U.S. because they are very concerned about the safety of COVID-19 vaccine(s) which is extraordinarily important. However, while vaccine safety is a prominent conversation, we’re not having a necessary conversation about what it means to be a part of society. The cost of living in society is that sometimes you do have to give up some personal freedoms because it is life or death, and I’m hoping we can start having that social conversation about what it means to care about public health and give up some of your freedoms for the good of everyone. The stakes are high and the more people that are on the side of science, the better off we will be.

Q: As of 2018, immunization rates in the U.S. are currently at 70.4% for children 19-35 months compared to 56.6% in 2010 for combined 7-vaccines series. What is it going to take to continue this increase in immunization rates in the U.S.?

It has to be a collaborative effort because when one problem is solved by one stakeholder, then there is another issue that needs to be addressed by another stakeholder. Bolstering the school incentive so that it becomes a requirement for children to have their vaccinations in order to go to school is also essential to raising immunization rates. Another effort to raise immunizations is to normalize vaccines. People should be looking around their community and see fellow humans who are vaccinated and living healthy, normal lives.

Header photo: A young boy waits for his flu shot as his father gets his shot first during a country-wide seasonal influenza program.

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