Vaccine hesitancy has become a rising public health concern.
Although its prevalence grew during the pandemic, vaccination reluctance is not limited to COVID-19. It is a longer-term issue with parents hesitant about the dangers (real or imagined) of vaccinating their children. A 2019 CDC survey found that one in four parents reported serious concerns about vaccinating their children.
In March 2020, an assessment of the latest CDC National Immunization Survey data showed that more than one-third of U.S. children aged 19 to 35 months were not following the recommended early childhood immunization schedule. In fact, vaccine hesitancy is now associated with an increase in vaccine-preventable disease outbreaks and epidemics in the U.S.
Historically pediatricians have worried the most about vaccine hesitancy, but the pandemic has spread the challenge to other subspecialties to become more relevant across patients of all ages. It’s a significant problem that warrants immediate attention by the medical community.
The Approach
At its core, vaccination is a battle to win hearts and minds.
The question is how to overcome reluctance born out of fear and misinformation. Here are six steps that could provide a workable solution.
1. Actively Seek to Keep Patients Engaged
Some pediatricians and primary care offices have vaccine policies requiring vaccinations. Although such policies underline the importance of vaccines, they also have a polarizing effect.
The goal, however, is not to drive people away but to keep them talking. That starts with listening to what people say, so you know where they are coming from and can engage in a personalized manner.
“People always ask me, ‘How do you convince somebody to get vaccinated?’ And the truth is, I think you listen before you talk,” said Rochelle P. Walensky, MD, MPH, director of the CDC, at the recent Conference on Retroviruses and Opportunistic Infections.
“You have to listen one by one. It’s not a monolith as to why people have not gotten vaccinated yet. That’s a lot of hard work, and that’s the work we have ahead.”
Listen to your patients at every visit and stay present at each encounter. Educate everyone in your practice on listening best practices. Getting your staff on board helps reinforce your teaching and increase parents’ understanding.
2. Work to Build Relationships Based on Trust
The issue isn’t merely about vaccines—it’s about the level of trust in the medical field. Changing hearts and minds requires rebuilding relationships.
Make it your goal to provide a positive patient experience based on mutual respect. Remember that confidence and trust are as much about how people feel (i.e., the “warm fuzzies”) than what they think.
3. Convey Your Expert Knowledge in a Relatable Way
Give your patients the benefit of your medical expertise, but don’t be condescending. Share your knowledge in a relatable and educational way, and include easy-to-understand statistics.
Rather than ignoring the side effects, be open and honest about the possibility of them occurring. But don’t let fear take over—frame the side effects in your favor.
4. Draw on Your Personal Experiences
People relate to personal stories. They evoke emotion, show understanding and empathy, and feel more “real” than mere facts and statistics.
To help drive home the importance and significance of vaccination protection, share (without disclosing protected health information) experiences about vaccine-preventable diseases. Include stories of side effects, particularly mild ones, that you consider helpful or applicable.
Also, talk about how vaccination programs have aided in the eradication of diseases like polio, smallpox, measles, and diphtheria.
5. Connect Vaccines to the Current Visit and Symptoms
Every clinical encounter provides an opportunity to establish trust, rapport, and understanding.
Try to bring up the efficacy and importance of vaccines in relation to the reasons for the visit without being too “one note.” When it comes to childhood vaccines, praise the parent(s) for their obvious concern for their child’s health and wellbeing. Connect overall health and immune strength to vaccines.
Also, talk about infectious diseases. Explain how one child comes in with strep received from another child at school, that diseases spread, and why it’s essential to protect oneself and others.
6. Be Kind, but Firm in Recommending Vaccination
Show compassion, but strongly recommend vaccination, supported by relevant facts, figures, literature, and anecdotes. If you need direction, in an issue of ACEPNow, Dr. David Talan covered some of the common misconceptions about immunizations and included resources to counter misinformation
Underline that they take your recommendations for antibiotics and other treatments as part of trusting you as their doctor. At the same time, acknowledge that it is only a recommendation. Parents get to make choices about their health and that of their family
The Outcome
It’s hard to change someone’s mind, combat misinformation through education, and stay calm and rational in the face of fear—but it’s worth the effort.
The goal is to heal and encourage health in others. Meet people where they are and do everything within your power to win their hearts and change their minds, understanding that, ultimately, the decision is theirs.
