Immunizations

Vaccine Hesitant Parents

​Parents want to do what is best for their child, even those who ask questions. While every parent is different and not all methods of communicating work for every parent or physician, below is a brief review of parental immunization attitudes and communication methods that have worked to reassure parents in some circumstances. To begin:

• Listen to parents’ concerns and acknowledge them in a non-confrontational manner. Allowing parents to express their concerns will increase their willingness to listen to the pediatrician’s views.
• Promote partnerships with parents in decision-making and personalize these relationships. Provide the important information first. Make sure the parent understands the information. Clarify and reaffirm parents’ correct beliefs about immunization and modify misconceptions.​​
• Discuss the benefits of vaccines and the possibility of adverse events. Be open about what is known about immunizations and what is not known. Provide parents with Vaccine Information Statements, educational resources, and reliable Web sites. Personalize the information provided to parents based on cultural beliefs, vaccine concerns, and literacy level.
• Stress the number of lives saved by immunization, as a positive approach, rather than focusing on the number of deaths from not immunizing.
• Discuss state laws for school entry and the rationale for them. Some parents disagree with mandatory immunization and resist immunization because they believe their rights as parents are being taken away. Explain that vaccines benefit individual children and communities through herd immunity.
• Provider attitudes and beliefs about vaccine safety have been linked to vaccination coverage in preschool children. The majority of parents believe immunization is important and trust pediatricians as the most important source of immunization information. ​ 
  Kimmel SR, Wolfe RM. Communicating the benefits and risks of vaccines. The Journal of Family Practice. 2005; 54:S51-S57
  Zhang J, Yu KF. What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA. 1998; 280:1690-1691

Types of parental immunization attitudes:

Parent Type	Belief about vaccines	Percentage of Parents
Immunization Advocates	Strongly agree vaccines are necessary and safe	33%
Go Along to Get Alongs	Agree vaccines are necessary and safe	26%
Health Advocate	Agree vaccines are necessary but are less sure about their safety	25%
Fence-sitters	Who slightly agree that vaccines are necessary and safe	13%
Worrieds	Slightly disagree that vaccines are necessary and strongly disagree that vaccines are safe	3%

 Gust, et al. American Journal of Health Behavior, 2005. http://www.ncbi.nlm.nih.gov/pubmed/15604052

Key points to consider:

• Parents from all groups include their health care provider as a source of information to help decide about their child’s health care.
• Most parents still vaccinate their children, despite concerns.

Strategies for Talking to Parents:​

Presumptive Vs. Participatory Recommendations

Researchers found that pediatricians who provided a “presumptive recommendation” – informed parents that shots were due, rather than a “participatory recommendation” – asking what the parent thought about shots, were more likely to see parents accept vaccines.