Health professionals can apply the 3C Model of Vaccine Hesitancy to support RSV vaccination among older adults

by Dr. Sherilyn Houle

In 2023, two vaccines were approved for use in Canada for the prevention of lower respiratory tract infections caused by respiratory syncytial virus (RSV) in people aged 60 years and older; however, their uptake may be hindered by vaccine fatigue, hesitancy, and persisting misconceptions that RSV is largely a concern among children. While hospitalization rates due to RSV are highest among children under the age of 1 year, mortality rates are highest among older adults. Reaching this population with safe and effective vaccines will save lives.

The 3C Model of Vaccine Hesitancy states that factors influencing hesitancy include complacency, confidence, and convenience. In our article published in the Canadian Pharmacists Journal, we use this model to provide strategies for health professionals to address complacency around the risks of RSV in older adults, instill confidence in the safety and effectiveness of vaccines available against RSV, and offer convenient access to vaccination services.

Complacency regarding RSV vaccination stems from the perception among both the public and some health professionals that it primarily causes severe illness among children and only contributes to cold-like symptoms among adults. Considering that over 70% of Canadians aged 65 and older recognize the risks of influenza and choose to be vaccinated against it each year, educating older adults that complications from RSV are similar in frequency and severity as influenza (including clinical outcomes such as pneumonia and quality of life outcomes such as loss of functional independence) is a potential strategy to support a decision to be vaccinated.

Confidence in RSV vaccines may be impacted by their relatively recent approval as well as a history of a failed vaccine candidate against RSV in the 1960s. Patients can be reassured that the cause of the failed trial in the past has been identified and addressed, and current vaccines have successfully demonstrated safety and efficacy in clinical trials.

Finally, convenient access to vaccination has become an increasingly important consideration to support vaccine uptake. The single dose regimen of both RSV vaccines ensures that protection is offered without the need to return for subsequent doses, and co-administration of RSV vaccine at the same time as other vaccines is advised. Offering RSV vaccination services through community pharmacies, which generally have greater geographic density and longer operating hours than other primary care providers, can also promote uptake.

RSV poses a significant threat to older adults, leading to substantial morbidity and mortality. Vaccination of this population will contribute to preventing RSV-related complications and should be proactively recommended by health professionals serving this population.

read the article

Article Details
RSV vaccination in older adults: Addressing vaccine hesitancy using the 3C model
Sherilyn K. D. Houle, Melissa K. Andrew
First Published November 24, 2023 Research Article
DOI: 10.1177/17151635231210879
Canadian Pharmacists Journal / Revue des Pharmaciens du Canada

About the Author

Featured

Dr. Sherilyn Houle is a pharmacist and Associate Professor at the University of Waterloo School of Pharmacy, with research and teaching interests in pharmacy practice to full scope with a focus on pharmacists as providers of vaccinations and travel health services.