Seminar on immunisation issues in Pazardzhik
The town of Pazardzhik was another destination for the discussions initiated by the Astra Forum Foundation on “Communication between doctors and patients on immunization issues“, which are part of a national program to increase immunization coverage in Bulgaria. The seminar was held on 11.05.2022.
Dr. Kremena Parmakova from the Ministry of Health presented the topic of the conference Immunizations – the main tool to fight communicable diseases. The presentation started with the Council of Europe’s recommendation to member states to strengthen cooperation in the fight against vaccine-preventable diseases. Although this call dates back to 2018, it is increasingly relevant today, as vaccination coverage among the population has declined in recent years and especially following the COVID-19 epidemic. The reasons for this are manifold, and what any doctor or health professional can do is to be well prepared on the topic of vaccines and able to properly communicate with patients.
The situation in Bulgaria shows that as regards compulsory immunisations, only the tuberculosis vaccine has achieved 96% coverage. In addition to the vaccines included in the Bulgarian immunisation calendar, the importance of the so-called recommended vaccines, which are administered to certain target groups of the population, was explained. The vaccine against COViD-19 is one of these vaccines. Dr. Parmakova talked about the difference between homologous (the same type of vaccine is used) and heterologous vaccination (different types of vaccine are used, etc., RNA and vector vaccine). Heterologous immunization leads to the generation of a more vigorous immune response.
Special time was spent discussing the Ukrainian refugee crisis as an impact on our healthcare system. The importance of establishing the vaccination status of Ukrainian citizens was emphasized and steps to ensure that Ukrainian citizens receive the missing immunizations were discussed. This is especially important for children who are more likely to have missed vaccinations. According to official data, vaccination coverage in Ukraine is lower than in our country. There are preconditions for outbreaks of infectious diseases.
The presentation by Assoc. Prof. Hristiana Batselova, lecturer at the Medical University of Plovdiv, was met with high interest. It focused on vaccines against COVID-19. A comparison was made between the development of immunity after a natural encounter with the virus and after receiving the vaccine. Attention was drawn to the fact that besides the varying severity of the course of the disease, the disease caused by COVID-19 leads to complications in patients of different duration and degree of damage. The most common long-term sequences are fatigue, headache, hair loss, shortness of breath and decreased concentration.
Despite the high risk of a severe course and long-term damage to health, many people do not opt for vaccination because of various concerns, often created by false information reaching them. Their main concerns are related to the safety of COVID-19 vaccines. In her presentation, Dr Batselova comprehensively analysed the most common fears of patients regarding the vaccines created so far and proved their untenability, especially in comparison to the danger posed by the disease itself.
The presentation concluded with the need to limit the spread of COVID-19 to the greatest extent possible. This can be achieved through vaccination. Only by preventing the virus from circulating in the population and multiplying will the possibility of mutations be eliminated.
On the topic of improving doctor-patient communication regarding vaccinations, Lyudmila Paneva from Astra Forum Foundation presented the method of motivational interviewing as a suitable approach to change people’s attitudes.
Patients’ opinions about COVID-19 vaccines are formed by different sources, some of which provide misleading or even false information. This is the reason why many people feel hesitant about the need for vaccination against COVID-19. General practitioners are highly trusted by their patients. They are therefore the professionals who could have an influence on vaccination coverage against this disease.
In order to influence patients’ attitudes, it is necessary to determine their initial attitudes, understand the reasons for the fears they may have and work to overcome them by providing facts and evidence after getting the patient’s approval.
The method of motivational interviewing is well suited to overcome patients’ vaccination hesitations as it addresses their personal, intrinsic motivation to change. The approach involves asking open-ended questions, listening to the answers and repeating them. Offering support, advice, encouragement, and information with patient consent is important.
The method of motivational interviewing does not reject but complements other approaches to doctor-patient communication. It offers a way of dealing with resistant talk against change and is well suited to working with so-called ‘difficult patients’.
After explaining the basic principles of motivational interviewing, Lyudmila Paneva conducted a demonstration of the method with the health professionals present at the meeting.
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.