The JITSUVAX Project


Vaccine hesitancy - the delay in acceptance or refusal of vaccines despite availability of vaccine services - has been cited as a serious threat to global health by the World Health Organization (WHO), attributing it to misinformation on the internet. The WHO has also identified Health Care Professionals (HCPs) as the most trusted influencers of vaccination decisions. JITSUVAX leverages those insights to turn toxic misinformation into a potential asset based on two premises:

  1. The best way to acquire knowledge and to combat misperceptions is by employing misinformation itself, either in weakened doses as a cognitive “vaccine”, or through thorough analysis of misinformation during “refutational learning”.
  2. HCPs form the critical link between vaccination policies and vaccine uptake. The principal objective of JITSUVAX is to leverage misinformation about vaccinations into an opportunity by training HCPs through inoculation and refutational learning, thereby neutralizing misinformation among HCPs and enabling them to communicate more effectively with patients.

JITSUVAX consists of four scientific work packages:

Work Package 1: Assessing vaccine hesitancy among health care professionals (HCPs) across Europe

The first work package consists of systematically measuring health care professionals’ (HCPs) attitudes towards vaccinations using a combination of interviews and questionnaires. This will be carried out in all of the participating countries. An assessment of HCPs attitudes is important because HCPs form the critical link.
WP1 has three objectives:

  1. To provide a systematic assessment of HCP attitudes towards vaccinations across all participating countries. The methodology will maximize comparability between countries by using a carefully-designed instrument that is cross-validated to ensure its applicability to the national context and prevailing practices in each county.
  2. To assess the effectiveness of contrarian arguments to optimise targeting of jiu jitsu techniques in WP2 and WP3.
  3. To provide validated outcome measures for WP3.

Work Package 2: Developing Jiu Jitsu interventions for HCPs and the general public

In the second work package, arguments and misinformation used by anti-vaccination activists will be analysed. This analysis will be used to provide material for cognitive ‘vaccination’ and refutational learning, two ways of addressing misperceptions that have been shown to be useful in other contexts. Novel tools that improve public resilience to misinformation will be developed along with tools to help HCPs develop their knowledge and communicate more effectively with patients.
WP2 has three objectives:

  1. To analyse existing argumentation by anti-vaccination activists in order to provide material for inoculation and refutational learning.
  2. To develop novel Jiu Jitsu approaches that can help improve public resilience to misinformation and HCP’s knowledge and attitudes concerning vaccinations.
  3. To develop tools that can enhance HCPs' communication ability.

Work Package 3: Converting Jiu Jitsu interventions into learning and communication tools for HCPs

In the third work package, the findings from the first two will be brought into practice. Several new tools will be explored, including interventions to be trialled in the training of HCPs.
WP3 has three objectives, all of which relate to the translation of the findings from WP1 and WP2 into practice:

  1. To field test the empathic refutational interview.
  2. To field test the inoculation talk that may be stimulated by HCPs.
  3. To test the efficacy of modifying the training of HCPs in the UK.
This WP will involve all participating countries. Unlike WP1, WP2 is designed to maximize diversity rather than uniformity: instead of synchronizing a single research task across countries, we designed WP3 to exploit the diversity of opportunities across the countries, with a different task designed for each team based on their unique, culturally-situated research strengths.

Work Package 4: Converting Jiu Jitsu interventions into communication tools for HCPs

In the fourth work package, the findings will be shared by developing a guidance document for HCPs and public health bodies, which will be disseminated across the globe via WHO, UNICEF and other organisations.
WP4 has three objectives:

  1. To design and develop a guidance document for HCPs on how to respond to misinformation in HCP-to-patient conversations.
  2. To design and develop a multiplier guide for trainers on how to train HCPs using simulation-based workshops.
  3. To conduct the first international simulation-based workshop on how to respond to misinformation in HCP-to-patient conversations.
The guidance document will be for any healthcare practitioner. It aims at
  1. increasing resilience among HCPs against misinformation around vaccination
  2. improving HCPs communication skills in HCP-to-patient conversations.
The guidance document will be a direct translation of the Jiu Jitsu interventions developed in WP2 and WP3 into practical recommendations and training modules for HCP. Thus, WP4 translates the essence of the results of the project into publicly understandable guidance. In addition to empirical findings, the content of WP4 will be reinforced by expert opinions from all members of the consortium, experiences from HCPs who participated in WP3, and previous research on HCP-to-patient conversations from the research areas of science communication, psychology and nursing.