In addition, real incentives and disincentives (economic or legal, for example) for acceptance or rejection of vaccines among institutions, individuals, and payors, should be considered.
• Give some attention to the concept of "personalized vaccinomics." This is a concept of personalized vaccination based on the idea that one size and dose does not fit all.
Eventually, phenotype/genotype databases will be large enough to make predictions about dosing needs (such as predicting which young women might respond to one dose of HPV vaccine, eliminating the need for all three doses), for example, so that the approach can be personalized.
• Ensure health care worker vaccine competency and compliance. Vaccine requirements for transmissible diseases among health care workers are needed, as are educational requirements for workers. A "nursing paradox" also needs to be addressed; studies suggest that while nurses spend the most time with patients and are the greatest influencers, they still tend to question the safety of vaccines more than any other health care worker category.
Several studies, including ones that I have conducted, show that there is very little in the way of vaccine education in nursing schools. It’s time to change that trend.
• Learn and utilize the science of motivation, change, and communication. This involves learning how people learn, how they think, and how they make decisions, and applying this through innovation. It also requires relentlessly exposing and rebutting dangerous and uniformed opinions for what they are.
Ample data demonstrate that we make fundamentally flawed decisions because of unconscious biases. It’s the way we’re wired. I think we would be wise to understand the role of cognitive bias and preferred cognitive styles in educating the public, and the power of emotive stories and parables.
Dr. Poland is director of the Mayo Clinic Vaccine Research Group, Rochester, Minn. He reported having relationships with the following companies: Merck, Avianax, Theraclone Sciences, Liquidia Technologies, Dynavax, PaxVax, and Novartis Vaccines and Diagnostics.