Associate Professor Margie Danchin

Taking the lead in vaccine uptake

It was a chance conversation around a campfire that kicked off a successful career in medicine for Associate Professor Margie Danchin (MBBS 1995, PhD 2006).

“In my last year of high school at Easter we went camping with the previous governor of Victoria, Professor David de Kretser, who was a family friend,” says Associate Professor Danchin. “He said to me, ‘Oh, why don't you do medicine? I think you'd make a great doctor’.”

She went on to study medicine at the University of Melbourne, deciding early on that paediatrics was the field for her. “I needed to do one year, my intern year, with adults and then the rest of my time has been in paediatrics. I loved it from the first day as a medical student and I've never left.”

Fate intervened once more when it came to her PhD.

“I saw an email advertising for a PhD early in my advanced training in general pediatrics and I thought, ‘oh, that sounds exciting’. It was literally serendipity … I’d never thought about doing a PhD before that project captured my interest,” says Associate Professor Danchin.

“Sometimes opportunities come your way and you just need to take them if they excite you.”

Building vaccine confidence

Her PhD took Associate Professor Danchin into the world of vaccines. Working with Professor Jonathan Carapetis (now Director of the Telethon Kids Institute, Perth), her project focused on the burden of group A streptococcal (GAS) sore throat and potential GAS vaccines.

After completing her PhD and working at the SickKids Hospital in Toronto, Canada, Associate Professor Danchin returned to Melbourne, where she embraced her passion for paediatrics and growing interest in vaccine research. She joined the well-known RV3-BB rotavirus vaccine program at the Murdoch Children’s Research Institute (MCRI) and worked with Professor Julie Bines (MD 2000) and Professor Ruth Bishop (BSc 1954, MSc 1958, PhD 1961, DSc 1979, DMedSc 2009), who discovered the rotavirus.

“I joined the program as a postdoc and helped run the clinical trials for the new generation oral neonatal rotavirus vaccine in Melbourne and New Zealand to prevent severe dehydrating gastro in kids,” Associate Professor Danchin says. “It was an exciting time and I’ve stayed in vaccine-related research ever since.”

After initially working on vaccine clinical trials and safety, Associate Professor Danchin’s research program shifted to the social and behavioral drivers of vaccine uptake and strategies to build vaccine confidence and ensure vaccines are used well.

Today, she is a mum of four kids and a consultant paediatrician at the Royal Children’s Hospital, the University of Melbourne Department of Paediatrics and MCRI, where she is Group Leader of Vaccine Uptake. She chairs the Collaboration on Social Science and Immunisation (COSSI), an international collaboration to improve vaccine confidence, demand and uptake. She is also Director of Clinician Scientist Pathways at Melbourne Medical School, a role in which she supports emerging professionals – especially women – to embrace both clinical medicine and research.

Taking on COVID-19

In yet another serendipitous moment, Associate Professor Danchin became Vaccine Uptake Group Leader at MCRI just two months before the COVID-19 pandemic hit Australia.

“Our work during the pandemic has truly been a collaborative effort with incredible colleagues within our group, across the Parkville precinct, nationally and internationally,” she says. “One of the positive outcomes has been how silos have come down and people have really come together with a common purpose.”

For Associate Professor Danchin, the science and psychology of effective communication and changing people’s behaviour presents an exciting challenge. “If you're looking at climate change, smoking, obesity or any number of campaigns, behaviour change is one of the hardest wicked problems to crack,” she says.

“Before the pandemic, one of the biggest challenges globally was that measles outbreaks were increasing. There was a 300 per cent increase in measles in 2019. Vaccine hesitancy was named as one of the top 10 global health threats in 2019 by WHO, and then the pandemic hit.”

“It's like a perfect storm in some ways, working in this space and the challenge of rolling out a whole of life vaccine program where we really need to work with everyone in the population to accept these COVID vaccines.”

Inspiring behaviour change

Associate Professor Danchin works with a huge range of stakeholders to identify which vaccine uptake barriers are impacting different groups.

“I get to work with so many diverse specialties and groups: political scientists, communication experts, social behavioral scientists, infectious diseases doctors, public health physicians, politicians and government officials. It's the most interesting and exciting space to work in,” she says.

This year she has dedicated a lot of time to building capacity through a Vaccine Champions program, in partnership with the Department of Health, which she describes as the most satisfying part of her COVID work.

“We work with community leaders, faith leaders, industry leaders and different healthcare providers to answer questions, give them knowledge and strategies, and empower them to be vaccine champions or advocates in their own communities or workplaces,” she says.

“We've probably run about 50 webinars now and reached over 10,000 people. We have, sometimes, up to 2000 people attending and we have extended periods of Q&A time – like a Town Hall.”

“We also do a segment on vaccine communication training with role plays, which people seem to love the most. It’s around practical tips on how to have an effective conversation with someone who might be vaccine hesitant and how you can approach that without confrontation.”

Cutting through the noise

Speaking to the media has become a large part of Associate Professor Danchin’s professional life, with demand exploding throughout the pandemic. She records podcasts, participates in regular webinars and RCH Facebook Live sessions and appears in videos on the University of Melbourne’s Vax Facts website to answer questions about common concerns and conspiracy theories.

“It's a lot of fun and it's a great way to actually translate evidence into action … rather than having it sit in manuscripts in a journal somewhere,” she says.

As Australia’s vaccination rates grow, Associate Professor Danchin says communication is key.

“At a whole of population level, people really understand that our only way out of this pandemic is for us to get high vaccine coverage in the community,” she says.

“We have seen hesitancy reduce and decline, but trust issues and hesitancy still exist in a lot of different cultural and at-risk groups. At times, trust has been eroded by difficult or confusing government messaging, public health messaging, and necessarily changing advice from ATAGI [Australian Technical Advisory Group on Immunisation], which needs to be responsive to the changing data during the pandemic.”

“It really highlights how important it is to engage with the community and listen. That's how you generate trust.”