Talking with Parents about Vaccines

Why it matters

Doctors, nurses, physician assistants, and office staff all play a key role in establishing and maintaining a practice-wide commitment to communicating effectively about vaccines and maintaining high vaccination rates.

Parents consider their child's healthcare professionals to be their most trusted source of information when it comes to vaccines. This is true even for parents who are vaccine-hesitant or who consider delaying one or more vaccines. You have a critical role in helping parents choose vaccines for their child.

Conversation strategies

With all you do, you may feel that long vaccine conversations are stressful when you also need to check physical and cognitive milestones and have a full schedule of patients. Vaccine conversations can also be uncomfortable in some situations. You can use these communication strategies and tips to effectively address questions you may hear from parents, including parents who choose not to vaccinate.

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Assume parents will vaccinate

Introduce the topic of vaccination with the assumption that most parents are planning to accept vaccines. State which vaccines the child needs to receive as though you presume that parents are ready to accept them during that visit. For example:

• Instead of saying "What do you want to do about shots?," say "Your child needs three shots today."

• Instead of saying "Have you thought about the shots your child needs today?," say "Your child needs DTaP, Hib, and Hepatitis B shots today."

A research study looking at health care professionals (HCPs) and parents' interactions during vaccine visits showed that parents were more likely to express concerns when providers used language that asked parents about their vaccination plans. In this study, the presumptive approach resulted in significantly more parents accepting vaccines for their child, especially at first-time visits1.

Give your strong recommendation

If parents are not ready to vaccinate, then share your strong vaccine recommendation. Parents consistently rank their child's doctor as their most trusted source for vaccine information. With this unique position, your strong recommendation is critical for vaccine acceptance. Clearly state your strong recommendation. If appropriate, you can add a brief supporting statement that uses a mix of science and anecdote, depending on what you think will be most effective with that parent. Share the importance of vaccines to protect children from potentially life-threatening diseases or talk about your personal experiences with vaccination. For example:

• "I strongly recommend your child get these vaccines today."

• "These shots are very important to protect him from serious diseases."

• "I believe in vaccines so strongly that I vaccinated my own children on schedule."

• "This office has given thousands of doses of vaccines, and we have never seen a serious reaction."

Listen to and respond to parents' questions

Although research shows most parents in the U.S. support vaccines, you will encounter parents with questions or concerns. If a parent seems hesitant about following the recommended vaccine schedule, this doesn't necessarily mean they won't accept vaccines. Sometimes parents simply want your answers to their questions. Your willingness to listen with empathy will play a major role in building trust in you, your recommendation, and vaccines.

When listening, seek to understand the context behind parents' questions before responding so you can be sure the information you provide is appropriate to their concerns. If you encounter questions you do not know the answer to, or information from sources you are unfamiliar with, it is best to acknowledge the parent's concerns and share what you do know. Offer to review the information they have found and, if necessary, schedule another appointment to discuss it further.

What if parents refuse to vaccinate?

If parents decline immunizations after your strong recommendation and conversation about their concerns, use the following strategies:

Continue the conversation about vaccines during the next visit and restate your strong recommendation.

Inform parents about clinical presentations of vaccine-preventable diseases, including early symptoms.

Remind parents to call before bringing their child into the office, clinic, or emergency department when the child is ill so health care professionals can take precautions to protect others. Explain that when scheduling an office visit for an ill child who has not received vaccines, you will need to take all possible precautions to prevent contact with other patients, especially those too young to be fully vaccinated and those who have weakened immune systems.

Share resources like Reasons to Vaccinate with parents.

You may wish to have parents sign AAP's Refusal to Vaccinate Form each time a vaccine is refused so that you have a record of their refusal in their child's medical file.

Wrapping up the conversation

Remember that success comes in many forms. It may mean that parents accept all vaccines when you recommend them, or that they schedule some vaccines for another day. For very vaccine-hesitant parents, success may simply mean agreeing to leave the door open for future conversations.

Work with parents to agree on at least one action, such as:

• Scheduling another appointment or
• Encouraging the parent to read additional information you provide them.

If a parent declines vaccines once, it does not guarantee they always will. Continue to remind parents about the importance of keeping their child up to date on vaccines during future visits and work with them to get their child caught up if they fall behind.