BACKGROUND: The widespread use of vaccines led to significant decline in multiple potentially fatal infectious diseases. Recently, there has been an increase in vaccine hesitancy. Measles and pertussis outbreaks throughout the United States have put a spotlight on this urgent healthcare issue. Motivational interviewing is a counseling tactic that is gaining popularity and is being studied for its efficacy in preventative medicine and psychological disorders. It aims to inspire people to make behavioral changes through collaborative relationships with their provider by understanding how current actions do not translate into their health goals. LITERATURE REVIEW FINDINGS: Vaccine hesitancy is growing. Communities with decreased immunization rates are associated with a higher risk of disease outbreak. Increasing rates of undervaccinated children are likely due to increases in non-medical exemptions. Many parents, regardless of their vaccine hesitancy status, are concerned about vaccine safety. Vaccine hesitant parents refuse vaccines due to philosophical and religious beliefs, conspiracy theories, and safety concerns. Parents feel that providers do not adequately address their concern. Providers report not having the training to discredit parental concerns. The majority of parents describe their child’s pediatrician as their most trusted source of vaccine information. Parents who receive vaccine information from a provider are more likely to comply with the recommended childhood vaccine schedule. The most efficient way to discuss vaccines with parents has yet to be determined. PROPOSED PROJECT: This is a proposed QI research project for the Pediatric Clinic at Boston Medical Center. Providers would be trained in motivational interviewing during several sessions that included lectures and small group practice sessions with systematic feedback. During the intervention, parents who refuse vaccines for their child, aged 0-6 years old, will receive motivational interviewing from the provider. The proportion of the vaccine hesitant parents who accept the offered vaccine after will be analyzed. The pre and post intervention vaccination rates for the entire clinic will also be assessed. Data collection will be preformed through retrospective chart review. The project aims to increase provider confidence on vaccine counseling, educate providers on reasons for hesitancy, and improve compliance with the CDC recommended vaccine schedule. CONCLUSION: While most Americans continue to vaccinate their children according to the CDC’s recommended schedule, constant vigilance is required to maintain high immunization rates to protect our communities. Motivational interviewing is goal-oriented to alter a specific behavior and would allow providers to engage in an open, persuasive dialogue about parental vaccine concerns.

Syftet med denna studie är att undersöka antivaccin-diskurser på Facebooksidan Kavla Ner och jämföra dem med tre antivaccin-diskurser tidigare funna av Kata (2010). Tidigare forskning visar att antivaccin-grupper utnyttjar postmodernistiskt tänkande och att sociala medier är ett kraftfullt verktyg vad gäller åsiktsbildning om vaccin. Därtill kan konspirationsteorier som sprids om vaccin bidra till en ökad tro på att vaccin är farligt.Materialet som analyseras är 30 inlägg från Facebooksidan Kavla Ner och studien bygger på Faircloughs (1992) tredimensionella modell för kritisk diskursanalys. Texterna har analyserats med hjälp av analysverktygen lexikala val och modalitet. Detta görs med utgångspunkt i teorier om ideologi och diskurs, postmodernism samt kulturell hegemoni.Resultatet av analysen visar förekomsten av antivaccin-diskurser och att två av de funna diskurserna stämmer överens med de Kata (2010) funnit. Därtill gjordes nya upptäckter i form av en ny diskurs och de kategoriserande teman Kata funnit utvecklades. Resultatet visade att en stor mängd av inläggen är färgade av ett postmodernistiskt tänkande. Konspirationsteorier visade sig också vara vanligt förekommande i inläggen. Slutsatsen av studien är att de sociala praktiker som påverkar antivaccin-diskursen även skulle kunna påverka andra områden, vilket ytterligare förklarar vikten av att förstå fenomenet vaccinmotstånd. / The purpose of this bachelor thesis is to examine anti-vaccine discourses on the Kavla Ner Facebook page and to compare them to three anti-vaccine discourses previously found by Kata (2010). Research shows that anti-vaccine communities utilize postmodern ways of thought, and that social media is a powerful tool when it comes to affecting people's opinions about vaccination. Furthermore, conspiracy theories which are spread on the internet can contribute to belief that vaccines are dangerous.The material which has been analyzed consists of 30 posts from the Kavla Ner Facebook page and the method is based on Fairclough’s (1992) three-dimensional model for critical discourse analysis. The texts have been analyzed using the tools lexical choices and modality, while drawing on theories about ideology and discourse, postmodernism and cultural hegemony.The result shows the presence of anti-vaccine discourses on the Facebook page, and that two of the discourses are consistent with those found by Kata (2010). In addition, a new discourse was found and the categorizing themes by Kata were expanded. Conspiracy theories proved to be common in the posts. The results also showed that a large number of the posts are characterized by postmodernist thinking. Finally, it is concluded that the social practices which influence the anti-vaccine discourse could affect other areas, which further explains the importance of understanding the phenomenon of vaccine resistance.