Seminar on immunisation problems in Montana
A discussion on the topic of “Doctor-patient communication in vaccination attitudes” was held at the Regional Health Inspectorate in Montana.
All general practitioners and specialists in outpatient care were invited to attend the seminar. The seminar is part of the initiative of Astra Forum Foundation within the national program aimed to increase immunization coverage in the country.
Assoc. Prof. Lyubomira Nikolaeva Glomb, Head of the Department of Virology at the National Center for Infectious and Parasitic Diseases (NCIPD) made a presentation on the topic “Immunizations – a key tool to fight infectious diseases”. She began her presentation with disturbing statistics about a decline in vaccination coverage in the global population in recent years. This is due not only to the COVID-19 pandemic, but also to widespread misinformation about vaccines. There is increased distrust and heightened fear of unproven adverse events associated with immunisations. It is important that health workers are sufficiently prepared and actively involved in actions to improve vaccination coverage. This is very important because even a short interruption or postponement of immunizations leads to an increased risk of outbreaks. In Bulgaria, according to 2021 data, immunisation coverage in terms of mandatory vaccines is below 90%, except for tuberculosis, where it remains close to 97%.
In addition to the efforts that need to be made to follow up on missed and delayed mandatory vaccinations, it is important to promote recommended immunizations, such as those against Human papilloma virus or rotavirus infections in children.
According to Assoc. Prof. Glomb, in the context of the refugee crisis, one major public health priority is to protect the country from the importation and spread of acute infectious diseases that have high epidemic potential, such as measles, polio or diphtheria. A worrying fact is the low immunisation coverage in Ukraine.
In order to support the efforts of healthcare professionals to achieve better vaccination coverage, Dr. Georgi Vassilev, a psychiatrist, proposed an effective method of communicating with patients who are hesitant about immunizations, namely the motivational interviewing method. This approach has recently been successfully practiced with patients who are hesitant about receiving the COVID-19 vaccine.
Motivational interviewing begins with a conversation about change, aiming to elicit the patient’s personal motivation to make this change. The method requires cooperation between doctor and patient and is based on the use of open-ended questions, giving support, information and advice with the client’s permission. As it is an approach originally applied for patients suffering from alcoholism, motivational interviewing addresses issues such as resistant talk and talking against change. This makes it a highly appropriate technique for approaching difficult patients.
When applying the motivational interviewing method, it is important to understand where the particular patient is in terms of the change we aim to achieve, as the amount of change possible depends on the current baseline state.
The presentation was followed by a practical demonstration of the motivational interviewing method before the audience.
The event is part of a national initiative of the Astra Forum Foundation and is supported by the America for Bulgaria Foundation, the WHO and UNICEF offices in Bulgaria, the Bulgarian Association for Innovative Medicine, ArFarm and in partnership with the Ministry of Health, the Bulgarian Medical Association and the national association of GPs in Bulgaria.